Provider Demographics
NPI:1053331074
Name:ALLEVA, JOSEPH THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:THOMAS
Last Name:ALLEVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 PFINGSTEN RD # 2000
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1339
Mailing Address - Country:US
Mailing Address - Phone:847-503-4500
Mailing Address - Fax:847-657-5754
Practice Address - Street 1:2180 PFINGSTEN RD # 2000
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1339
Practice Address - Country:US
Practice Address - Phone:847-503-4500
Practice Address - Fax:847-657-5754
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090608208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036090608Medicaid
IL250011789OtherRAILROAD MEDICARE
IL1620385OtherBLUE SHIELD
IL571840Medicare PIN
IL250011789OtherRAILROAD MEDICARE
ILL76177Medicare PIN