Provider Demographics
NPI:1205907425
Name:LINDER, ALLISON JEAN (DC)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:JEAN
Last Name:LINDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:IL
Mailing Address - Zip Code:61231-1861
Mailing Address - Country:US
Mailing Address - Phone:309-582-2422
Mailing Address - Fax:309-582-2425
Practice Address - Street 1:802 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:IL
Practice Address - Zip Code:61231-1861
Practice Address - Country:US
Practice Address - Phone:309-582-2422
Practice Address - Fax:309-582-2425
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009061111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL350050239OtherRAILROAD MEDICARE
IL06626451OtherBLUE CROSS BLUE SHIELD
IL038009061Medicaid
IL350050239OtherRAILROAD MEDICARE
IL581130Medicare ID - Type Unspecified