Healthcare Provider Details

I. General information

NPI: 1891400982
Provider Name (Legal Business Name): SYDNEY ALLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 10/14/2026
Certification Date: 10/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 SIBLEY ST STE A
HAMMOND IN
46320-1725
US

IV. Provider business mailing address

31 SIBLEY ST STE A
HAMMOND IN
46320-1725
US

V. Phone/Fax

Practice location:
  • Phone: 219-802-8800
  • Fax: 708-631-2783
Mailing address:
  • Phone: 219-802-8800
  • Fax: 708-631-2783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10003902A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: