Healthcare Provider Details

I. General information

NPI: 1326973348
Provider Name (Legal Business Name): ALISON GRAY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 N KIMBALL AVE STE 205D
CHICAGO IL
60647-4805
US

IV. Provider business mailing address

513 N CLAREMONT AVE UNIT 3
CHICAGO IL
60612-2195
US

V. Phone/Fax

Practice location:
  • Phone: 773-808-0174
  • Fax:
Mailing address:
  • Phone: 773-808-0174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227021963
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: