Healthcare Provider Details

I. General information

NPI: 1174187926
Provider Name (Legal Business Name): ALLISON SEREY OBERST MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON CHRISTINE SEREY

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7435 W TALCOTT AVE
CHICAGO IL
60631-3707
US

IV. Provider business mailing address

5301 S CONGRESS AVE
ATLANTIS FL
33462-1149
US

V. Phone/Fax

Practice location:
  • Phone: 773-792-7921
  • Fax:
Mailing address:
  • Phone: 561-548-3836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number125-073710
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME156301
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: