Healthcare Provider Details

I. General information

NPI: 1497678890
Provider Name (Legal Business Name): ALLYSON LAMKIN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 4TH ST # 3309
PERU IL
61354-3309
US

IV. Provider business mailing address

2816 N ROCKWELL ST UNIT S
CHICAGO IL
60618-7833
US

V. Phone/Fax

Practice location:
  • Phone: 815-223-0151
  • Fax:
Mailing address:
  • Phone: 815-312-7292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046.012099
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: