Provider Demographics
NPI:1598283913
Name:TURNER, ALLIE JORDAN
Entity Type:Individual
Prefix:
First Name:ALLIE
Middle Name:JORDAN
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAWN
Mailing Address - State:IL
Mailing Address - Zip Code:62898-1119
Mailing Address - Country:US
Mailing Address - Phone:618-927-8659
Mailing Address - Fax:
Practice Address - Street 1:602 NORTH ST
Practice Address - Street 2:
Practice Address - City:WOODLAWN
Practice Address - State:IL
Practice Address - Zip Code:62898-1119
Practice Address - Country:US
Practice Address - Phone:618-927-8659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.004676235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist