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Individual

ALISSA KIRCHNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
215 E 1ST ST, DIXON, IL 61021-3166
(815) 285-5575
Mailing address
403 E 1ST ST, DIXON, IL 61021-3116
(815) 285-5531

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.003479
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36-1000540-01
IL
Enumeration date
11/19/2015
Last updated
11/19/2015
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