Healthcare Provider Details

I. General information

NPI: 1932613148
Provider Name (Legal Business Name): ALLISON JULIA YEMM P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 LOCUST ST
STERLING IL
61081-1101
US

IV. Provider business mailing address

1809 LOCUST ST
STERLING IL
61081-1101
US

V. Phone/Fax

Practice location:
  • Phone: 815-632-5285
  • Fax: 815-632-5824
Mailing address:
  • Phone: 815-632-5285
  • Fax: 815-632-5824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.023439
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: