Provider Demographics
NPI:1225489172
Name:YOUNG, ALISON DAWN TRAFFANSTEDT (DPM)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:DAWN TRAFFANSTEDT
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N MICHIGAN AVE STE 1129
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3478
Mailing Address - Country:US
Mailing Address - Phone:312-372-0919
Mailing Address - Fax:
Practice Address - Street 1:30 N MICHIGAN AVE STE 1129
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3478
Practice Address - Country:US
Practice Address - Phone:312-372-0919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL135.000927213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist