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Organization

JAMES R. ALLEN, M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY M. SMITH (BILLER/CODER)
(815) 942-5200
Entity
Organization

Contact information

Practice address
1300 DRESDEN DR, MORRIS, IL 60450-2476
(815) 942-5200
(815) 942-5330
Mailing address
1300 DRESDEN DR, MORRIS, IL 60450-2476
(815) 942-5200
(815) 942-5330

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036078159
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0003200054
BLUE CROSS BLUE SHIELD
IL
01
020019476
RAIL ROAD MEDICARE
IL
01
020442
HEALTH ALLIANCE
IL
05
036078159
IL
Enumeration date
06/05/2006
Last updated
09/18/2008
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