Provider Demographics
NPI:1134876188
Name:SHAMRAY, ALLA
Entity type:Individual
Prefix:
First Name:ALLA
Middle Name:
Last Name:SHAMRAY
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 1:210 OLD OAK DR APT 261
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-3627
Mailing Address - Country:US
Mailing Address - Phone:224-245-1676
Mailing Address - Fax:
Practice Address - Street 1:210 OLD OAK DR APT 261
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-3627
Practice Address - Country:US
Practice Address - Phone:224-245-1676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant