Provider Demographics
NPI:1568664092
Name:RODGERS, ALLISON KAY (MD)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:KAY
Last Name:RODGERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 PATRIOT BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8022
Mailing Address - Country:US
Mailing Address - Phone:847-129-2188
Mailing Address - Fax:847-998-6880
Practice Address - Street 1:2555 PATRIOT BLVD STE 100
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026
Practice Address - Country:US
Practice Address - Phone:847-998-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57009018207V00000X
IL036127088207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194260901Medicaid
TX194260901Medicaid
TX8K8251Medicare PIN