Healthcare Provider Details

I. General information

NPI: 1447162342
Provider Name (Legal Business Name): AMA PT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 W POLK ST STE G15
CHICAGO IL
60605-2768
US

IV. Provider business mailing address

135 SANDERS RD
NORTHBROOK IL
60062-1103
US

V. Phone/Fax

Practice location:
  • Phone: 312-834-3533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ALISON DADRASS
Title or Position: EXECUTIVE DIRECTOR
Credential: LSW, LBA
Phone: 734-612-9092