Provider Demographics
NPI:1093184087
Name:CARLSON, ALLISON
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 RAND RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2359
Mailing Address - Country:US
Mailing Address - Phone:847-324-3976
Mailing Address - Fax:847-929-1154
Practice Address - Street 1:27401 W HIGHWAY 22
Practice Address - Street 2:SUITE 125
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5999
Practice Address - Country:US
Practice Address - Phone:847-381-0388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-19
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant