Active NPI
Airline Care Clinic PLLC
- Family Nurse Practitioner
- East Alton, IL
National Provider Identifier
1992556427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- 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
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elizabeth Dykeman
- Title
- Owner
- Phone
- (314) 374-9965
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
33 E Airline Dr
East Alton, IL 62024-1703
Mailing address
33 E Airline Dr
East Alton, IL 62024-1703
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2345056 | Airline Care Clinic, PLLC | Certificate of waiver | Jun 3, 2028 |
National Provider Directory
National Provider DirectoryLocations
33 E Airline Dr
East Alton, IL 62024
Phone (618) 258-7600
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Bethalto, IL
- NPI 1851308092
NPI Registry JSON
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": []
}
Other providers in East Alton, IL
Sources for this page
- 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.