Healthcare Provider Details

I. General information

NPI: 1659700532
Provider Name (Legal Business Name): ALISON WEBB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2013
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 VILLAGE CIRCLE DR
PALOS PARK IL
60464-3541
US

IV. Provider business mailing address

18604 MAPLE AVE
COUNTRY CLUB HILLS IL
60478-5692
US

V. Phone/Fax

Practice location:
  • Phone: 708-407-1388
  • Fax:
Mailing address:
  • Phone: 708-407-1388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056.008964
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number056.008964
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: