Healthcare Provider Details

I. General information

NPI: 1003363029
Provider Name (Legal Business Name): ALLISON TERWILLIGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON RUSSELL RN

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 W 16TH ST STE 4300
INDIANAPOLIS IN
46202-2394
US

IV. Provider business mailing address

355 W 16TH ST STE 4300
INDIANAPOLIS IN
46202-2394
US

V. Phone/Fax

Practice location:
  • Phone: 317-503-9908
  • Fax:
Mailing address:
  • Phone: 541-768-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number01100672A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: