Provider Demographics
NPI:1255325023
Name:ALLEN, NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1535 LAKE COOK RD
Mailing Address - Street 2:SUITE 601
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1447
Mailing Address - Country:US
Mailing Address - Phone:847-509-0270
Mailing Address - Fax:847-509-0273
Practice Address - Street 1:1535 LAKE COOK RD
Practice Address - Street 2:SUITE 601
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1447
Practice Address - Country:US
Practice Address - Phone:847-509-0270
Practice Address - Fax:847-509-0273
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360407732084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036040773Medicaid
IL036040773Medicaid
ILD12410Medicare UPIN