Provider Demographics
NPI:1134137268
Name:QUADHAMER, ALLISON WOLAK (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:WOLAK
Last Name:QUADHAMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:MARIE
Other - Last Name:WOLAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:383 BIG PINE DR.
Mailing Address - Street 2:PO BOX 335
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906
Mailing Address - Country:US
Mailing Address - Phone:765-607-4671
Mailing Address - Fax:
Practice Address - Street 1:501 HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NE
Practice Address - Zip Code:68456-6079
Practice Address - Country:US
Practice Address - Phone:402-534-2203
Practice Address - Fax:402-534-2204
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010513111N00000X
NE1562111N00000X
IN08002929A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1L0100OtherJOHN DEERE HEALTH
IL5782014OtherBLUE CROSS
IL110621OtherHEALTH ALLIANCE