Provider Demographics
NPI:1700243631
Name:ALANO, JOHN TRINIDAD
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:TRINIDAD
Last Name:ALANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 WILMETTE AVE
Mailing Address - Street 2:UNIT 3C
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-3283
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 CENTRAL AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2683
Practice Address - Country:US
Practice Address - Phone:847-256-1705
Practice Address - Fax:847-256-7345
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070015214225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070015214OtherSTATE LICENSED