Individual
ANDRE LASHAWN ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CEO
Contact information
Practice address
20280 GOVERNORS HWY STE 206, OLYMPIA FIELDS, IL 60461-1068
(708) 898-0635
Mailing address
20280 GOVERNORS HWY STE 206, OLYMPIA FIELDS, IL 60461-1068
(708) 898-0635
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3129197649
—
IL
Enumeration date
02/14/2022
Last updated
02/14/2022
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