Healthcare Provider Details

I. General information

NPI: 1316455108
Provider Name (Legal Business Name): ALLISON ZIEGLER FIELDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2018
Last Update Date: 09/11/2025
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N WILLIAMSBURG DR STE A
BLOOMINGTON IL
61704-7721
US

IV. Provider business mailing address

205 N WILLIAMSBURG DR STE A
BLOOMINGTON IL
61704-7721
US

V. Phone/Fax

Practice location:
  • Phone: 309-306-1086
  • Fax:
Mailing address:
  • Phone: 309-306-1086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number041300736
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: