Individual ProviderAlicia Kay Vander WalRegistered NurseNursing Service ProvidersPractice Address1015 W Lawrence Ave Fl 2, Chicago, IL 60640-5017(773) 751-1731(616) 848-0402PECOS EnrollmentBased on the most recent information from CMS, provider Alicia Kay Vander Wal does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1891256020Provider TypeIndividualFull NameVander Wal, Alicia KayTitleMs.CredentialRNGenderFemaleSole ProprietorNoEnumeration Date3/29/2019Last Updated4/24/2019Contact InformationPractice LocationPractice Address1015 W Lawrence Ave Fl 2, Chicago, IL 60640-5017Phone(773) 751-1731Fax(773) 275-3695Mailing LocationMailing Address4368 72nd Ave, Zeeland, MI 49464-9459Phone(616) 848-0402FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense041478493IllinoisCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense4704315107Michigan