Healthcare Provider Details

I. General information

NPI: 1831211622
Provider Name (Legal Business Name): ALISON M SCHOEN P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W HARRISON ST
CHICAGO IL
60612-3714
US

IV. Provider business mailing address

1700 BUENA VISTA DR
WHEATON IL
60187-7745
US

V. Phone/Fax

Practice location:
  • Phone: 773-869-7488
  • Fax: 773-869-3578
Mailing address:
  • Phone: 773-869-7488
  • Fax: 773-869-3578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085-002623
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number085-002623
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: