Provider Demographics
NPI:1295804797
Name:O'CONNOR, ALLISON MITCHELL (PT)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:MITCHELL
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:LEIGH
Other - Last Name:SOLOMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1405 N. HUNT CLUB ROAD
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031
Mailing Address - Country:US
Mailing Address - Phone:847-855-2890
Mailing Address - Fax:847-855-2147
Practice Address - Street 1:1405 N. HUNT CLUB ROAD
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031
Practice Address - Country:US
Practice Address - Phone:847-855-2890
Practice Address - Fax:847-855-2147
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070009038225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist