Airline Care Clinic PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

AIRLINE CARE CLINIC PLLC

Practice address

33 E Airline Dr
East Alton, IL 62024-1703

Phone

(618) 908-8602

NPI assigned

Apr 1, 2024

Last updated

Apr 1, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth DykemanNPI 1063128494

Title

Owner

Phone

(314) 374-9965

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Suzan Dykeman, FNP-C

  • Family Nurse Practitioner
  • Webster Groves, MO
  • NPI 1063128494
  Authorized official Same address or phone
• Thomas Lawrence Kaltenbronn, D.C

  • Chiropractor
  • Bethalto, IL
  • NPI 1851308092
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1992556427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 E AIRLINE DR",
            "city": "EAST ALTON",
            "state": "IL",
            "postal_code": "620241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 E AIRLINE DR",
            "city": "EAST ALTON",
            "state": "IL",
            "postal_code": "620241703",
            "telephone_number": "618-908-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIRLINE CARE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "DYKEMAN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-374-9965"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nicole Andrea Bennett, PMHNP-BC
• Bridge of Hope Counseling Services PC

• Family Nurse Practitioner in East Alton, IL
• Providers in East Alton, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.