Provider Demographics
NPI:1093026684
Name:CORRO, ALLISON CLAIRE (PA)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:CLAIRE
Last Name:CORRO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 W CENTRAL RD STE 6200
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2378
Mailing Address - Country:US
Mailing Address - Phone:847-618-0730
Mailing Address - Fax:847-618-0799
Practice Address - Street 1:880 W CENTRAL RD STE 6200
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2378
Practice Address - Country:US
Practice Address - Phone:847-618-0730
Practice Address - Fax:847-618-0799
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-003775363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL085003775OtherSTATE LICENSE
IL209000195OtherSTATE LICENSE