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General NPI Number Information
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NPI Number | 1356987168
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Entity Type | Individual
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Provider Name | ALYSSA HOLUM DC
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Gender | Female
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Dates
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Enumeration Date | 11/27/2019
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 1400 W NORTHWEST HWY
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City | PALATINE
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State | IL
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Zip | 60067-1837
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Country | US
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Telephone | 847-496-4567
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Fax |
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Provider Business Mailing Address
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Address Line | 543 HAMILTON AVE
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City | WESTMONT
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State | IL
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Zip | 60559-1274
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Country | US
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Telephone |
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Fax |
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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 | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number | 038.013430
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License Number State | IL
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