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Organization

JOHN WILLIAM ALLEN, PSY.D. P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN WILLIAM ALLEN PSY.D. (CLINICAL PSYCHOLOGIST)
(773) 478-2982
Entity
Organization

Contact information

Practice address
4055 W PETERSON AVE, STE. 201, CHICAGO, IL 60646-6182
(773) 478-2982
(773) 478-8105
Mailing address
4055 W PETERSON AVE, STE. 201, CHICAGO, IL 60646-6182
(773) 478-2982
(773) 478-8105

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
071-007404
IL
305R00000X
Preferred Provider Organization
Primary
071-007404
IL

Other

Enumeration date
07/23/2009
Last updated
07/23/2009
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