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General NPI Number Information
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NPI Number | 1356423651
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Entity Type | Individual
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Provider Name | VIRGINIA THERESE ALLEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 1S224 SUMMIT AVE SUITE 106
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-3983
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Country | US
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Telephone | 630-953-1190
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Fax | 630-953-1102
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Provider Business Mailing Address
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Address Line | 1S224 SUMMIT AVE SUITE 106
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-3983
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Country | US
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Telephone | 630-953-1190
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Fax | 630-953-1102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 36-084775
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License Number State | IL
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