Healthcare Provider Details

I. General information

NPI: 1043135932
Provider Name (Legal Business Name): ALLISON DENNEMANN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 W ROOSEVELT RD
CHICAGO IL
60608-1336
US

IV. Provider business mailing address

1640 W ROOSEVELT RD APT 15
CHICAGO IL
60608-1316
US

V. Phone/Fax

Practice location:
  • Phone: 312-413-8043
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: