Healthcare Provider Details

I. General information

NPI: 1467172395
Provider Name (Legal Business Name): ALISON MICHELLE MAYER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S WASHINGTON AVE STE 202
PARK RIDGE IL
60068-4293
US

IV. Provider business mailing address

2541 KINGSTON DR
NORTHBROOK IL
60062-6509
US

V. Phone/Fax

Practice location:
  • Phone: 224-279-1060
  • Fax:
Mailing address:
  • Phone: 847-542-1097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: