Individual
ALISSA ZIMMERMAN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
815 MAIN ST, PEORIA, IL 61602-1076
(309) 672-4977
Mailing address
5100 RELIABLE PKWY, CHICAGO, IL 60686-0051
(309) 672-4809
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125062318
IL
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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