Healthcare Provider Details

I. General information

NPI: 1508791021
Provider Name (Legal Business Name): ALLISON POPEK RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13071 DUNMOOR DR
LEMONT IL
60439-2741
US

IV. Provider business mailing address

11560 S KEDZIE AVE
MERRIONETTE PARK IL
60803-4517
US

V. Phone/Fax

Practice location:
  • Phone: 708-792-0162
  • Fax:
Mailing address:
  • Phone: 708-792-0162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-466777
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: