Healthcare Provider Details

I. General information

NPI: 1710063656
Provider Name (Legal Business Name): ALISON MEANOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 WEST PARK STREET
CHAMPAIGN IL
61820
US

IV. Provider business mailing address

2018 FLETCHER ST APT 1
URBANA IL
61801-6882
US

V. Phone/Fax

Practice location:
  • Phone: 217-373-2436
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: