Provider Demographics
NPI:1346971504
Name:ALLEN, CLOE (IOM)
Entity Type:Individual
Prefix:
First Name:CLOE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:IOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E HURON ST STE 1-200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2909
Mailing Address - Country:US
Mailing Address - Phone:312-503-7975
Mailing Address - Fax:
Practice Address - Street 1:2915 W BITTERS RD STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-2007
Practice Address - Country:US
Practice Address - Phone:210-598-2800
Practice Address - Fax:210-598-4236
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic