Provider Demographics
NPI:1073691135
Name:ALLIED ALPHA ASSISTANTS, INC
Entity Type:Organization
Organization Name:ALLIED ALPHA ASSISTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:RSA
Authorized Official - Phone:630-241-1933
Mailing Address - Street 1:6330 BELMONT RD
Mailing Address - Street 2:UNIT 5
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-2106
Mailing Address - Country:US
Mailing Address - Phone:630-241-1933
Mailing Address - Fax:630-216-1105
Practice Address - Street 1:6330 BELMONT RD
Practice Address - Street 2:UNIT 5
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-2106
Practice Address - Country:US
Practice Address - Phone:630-241-1933
Practice Address - Fax:630-216-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238000017174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL238000017OtherREGISTERED SURGICAL ASST.