Provider Demographics
NPI:1235158858
Name:ACKERMAN, ALLISON D (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:D
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 LAKE COOK RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-5607
Mailing Address - Country:US
Mailing Address - Phone:847-444-0214
Mailing Address - Fax:847-444-0214
Practice Address - Street 1:400 LAKE COOK RD
Practice Address - Street 2:SUITE 106
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5607
Practice Address - Country:US
Practice Address - Phone:847-444-0214
Practice Address - Fax:847-444-0214
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical