IndividualActive
Alyssa Ketchum, PA-C
NPI 1104200625 · Surgical Physician Assistant · Chicago, IL
Provider details
- NPI number
- 1104200625
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 085005549 (IL)
Practice location
676 N Saint Clair St Ste 1900
Chicago, IL 60611-2986
Phone: (312) 926-5354
Mailing address
676 N Saint Clair St Ste 1900
Chicago, IL 60611-2986
Registry dates
- Enumerated
- 2015-07-14
- Last updated
- 2018-12-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.