Healthcare Provider Details

I. General information

NPI: 1164286431
Provider Name (Legal Business Name): ALLISON LYNN ADAIR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 N LA SALLE DR
CHICAGO IL
60614-6000
US

IV. Provider business mailing address

2930 N COMMONWEALTH AVE APT 205
CHICAGO IL
60657-6285
US

V. Phone/Fax

Practice location:
  • Phone: 312-248-1801
  • Fax:
Mailing address:
  • Phone: 260-443-8344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number152.001180
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: