Provider Demographics
NPI:1669144416
Name:ALLEMAN, GRACE (MHS, LPC, CADC)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:ALLEMAN
Suffix:
Gender:F
Credentials:MHS, LPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4323 KATHLEEN LN
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-5749
Mailing Address - Country:US
Mailing Address - Phone:312-771-1109
Mailing Address - Fax:
Practice Address - Street 1:5210 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2460
Practice Address - Country:US
Practice Address - Phone:708-423-3361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.016706101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor