Provider Demographics
NPI:1962827774
Name:SIMMONDS, ALLYSON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:SIMMONDS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6219 ANVIL RD
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60012-1180
Mailing Address - Country:US
Mailing Address - Phone:812-455-2817
Mailing Address - Fax:
Practice Address - Street 1:6219 ANVIL RD
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60012-1180
Practice Address - Country:US
Practice Address - Phone:812-455-2817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.020548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist