MEDICARE: FAYE ALLEN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	3893	IA

General Provider Information

NPI Number	:	1154366383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAYE ALLEN DPT

Provider Business Mailing Address
First Line	:	205 W WACKER DR
Second Line	:	SUITE 1020
City	:	CHICAGO
State	:	IL
Zip	:	60606-1216
Country	:	US
Telephone Number	:	312-640-0329
Fax Number	:

Provider Business Practice Location Address
First Line	:	7011 DOUGLAS AVE
Second Line	:
City	:	URBANDALE
State	:	IA
Zip	:	50322-3223
Country	:	US
Telephone Number	:	515-251-3700
Fax Number	:	515-251-3733

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	11/25/2008

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