Provider Demographics
NPI:1760967327
Name:ALLAS, GLORIA AURORA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:AURORA
Last Name:ALLAS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1183 JOHNSON DR APT 2812
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6955
Mailing Address - Country:US
Mailing Address - Phone:872-484-3700
Mailing Address - Fax:
Practice Address - Street 1:1183 JOHNSON DR APT 2812
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-6955
Practice Address - Country:US
Practice Address - Phone:872-484-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-30
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty