Provider Demographics
NPI:1265688576
Name:ALISON W BRETT, PHD, P.C,
Entity type:Organization
Organization Name:ALISON W BRETT, PHD, P.C,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:W
Authorized Official - Last Name:BRETT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-476-6050
Mailing Address - Street 1:PO BOX 5504
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60204-5504
Mailing Address - Country:US
Mailing Address - Phone:847-476-6050
Mailing Address - Fax:
Practice Address - Street 1:461 BURTON AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-4940
Practice Address - Country:US
Practice Address - Phone:847-476-6050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL410280Medicare UPIN
IL541400Medicare UPIN