Provider Demographics
NPI:1477913820
Name:ALLEN, DEBORAH REGINA (APRN)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:REGINA
Last Name:ALLEN
Suffix:
Gender:
Credentials:APRN
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:REGINA
Other - Last Name:DARDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:6033 N SHERIDAN RD APT 13J
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3010
Mailing Address - Country:US
Mailing Address - Phone:804-441-1833
Mailing Address - Fax:
Practice Address - Street 1:1300 W DEVON AVE FL 7
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-1302
Practice Address - Country:US
Practice Address - Phone:773-751-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-28
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019480363LP0200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty