Individual
MR. BRIAN J ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2101 WAUKEGAN RD, SUITE 100, BANNOCKBURN, IL 60015-1836
(847) 236-1194
(847) 236-1195
Mailing address
2101 WAUKEGAN RD, SUITE 100, BANNOCKBURN, IL 60015-1836
(847) 236-1194
(847) 236-1195
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011163
IL
111N00000X
Chiropractor
S03483
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101022
JHHC
MD
01
—
204558300
MAMD
—
01
—
22281
ALLIANCE
MD
01
—
273638
AETNA
MD
01
—
6978412004
ASHN
—
01
—
DD0972
MEDICARE RR
—
01
—
E466
BSDC
DC
01
—
S765AL
BSMD
MD
Enumeration date
03/21/2007
Last updated
12/22/2010
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