Provider Demographics
NPI:1396177945
Name:ALLISON, LASHAUNA (OTR/L)
Entity Type:Individual
Prefix:
First Name:LASHAUNA
Middle Name:
Last Name:ALLISON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8751 S PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60620-1323
Mailing Address - Country:US
Mailing Address - Phone:773-443-4181
Mailing Address - Fax:
Practice Address - Street 1:8751 S PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-1323
Practice Address - Country:US
Practice Address - Phone:773-443-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056008263225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist