Provider Demographics
NPI:1225210784
Name:VIOLA, ALINA S (PSYD)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:S
Last Name:VIOLA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4256 N RAVENSWOOD AVE
Mailing Address - Street 2:STE. 302
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-1110
Mailing Address - Country:US
Mailing Address - Phone:773-398-7562
Mailing Address - Fax:773-398-7562
Practice Address - Street 1:4256 N RAVENSWOOD AVE
Practice Address - Street 2:STE. 302
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-1110
Practice Address - Country:US
Practice Address - Phone:773-398-7562
Practice Address - Fax:773-398-7562
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007391103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical