MEDICARE: MRS. ALLISON LR SOWARD PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	085.003272	IL

General Provider Information

NPI Number	:	1891942173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALLISON LR SOWARD PA-C

Provider Business Mailing Address
First Line	:	880 W CENTRAL RD STE 4400
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2386
Country	:	US
Telephone Number	:	847-483-9400
Fax Number	:	847-483-9426

Provider Business Practice Location Address
First Line	:	880 W CENTRAL RD
Second Line	:	SUITE 3800
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2369
Country	:	US
Telephone Number	:	847-483-9400
Fax Number	:	847-483-9808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	05/11/2021

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