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NPI Code Detail

MEDICARE: ALLINA HEALTH SYSTEM

MEDICARE: ALLINA HEALTH SYSTEM
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
1261Q00000XClinic/Center
2208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1528259132
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLINA HEALTH SYSTEM
Provider Business Mailing Address
First Line : PO BOX 43
Second Line : MR 10585
City : MINNEAPOLIS
State : MN
Zip : 55440-0043
Country : US
Telephone Number : 612-262-1166
Fax Number :
Provider Business Practice Location Address
First Line : 2833 CHICAGO AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-1319
Country : US
Telephone Number : 612-863-3333
Fax Number : 612-863-3107
Authorized Official
Title or Position : COO
Name : DOMINCA TALLARICO
Credential :
Telephone Number : 612-222-2222
Provider Enumeration Date : 08/08/2007
Last Update Date : 02/24/2025

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