Healthcare Provider Details

I. General information

NPI: 1811487358
Provider Name (Legal Business Name): ALLISON JOANNE MAJERCIK DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 E ERIE ST
CHICAGO IL
60611-3167
US

IV. Provider business mailing address

805 N LA SALLE DR UNIT 1607
CHICAGO IL
60610-3257
US

V. Phone/Fax

Practice location:
  • Phone: 312-238-1000
  • Fax:
Mailing address:
  • Phone: 913-486-1403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.023555
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: