Individual
ALLISON JANE LOVERING FASTERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, GCS, IADN
Contact information
Practice address
2500 RIDGE AVE STE 110, EVANSTON, IL 60201-2468
(800) 974-4378
(630) 515-1536
Mailing address
24014 W RENWICK RD UNIT 206, PLAINFIELD, IL 60544-8711
(800) 974-4378
(630) 515-1536
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070022505
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070022505
STATE LICENSE
IL
Enumeration date
09/15/2016
Last updated
01/19/2023
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