Individual
MRS. ALISON FRASOR MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070012049
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS OF IL
IL
01
—
1623066
BCBS PROVIDER #
IL
01
—
367885100
US DEPT OF LABOR PROVIDER
IL
01
—
567770
MEDICARE GROUP NUMBER
IL
01
—
568150
MEDICARE GROUP NUMBER
IL
01
—
CJ4383
R.R. MEDICARE GRP #
IL
01
—
P00224257
R.R. MEDICARE PIN #
IL
Enumeration date
08/08/2007
Last updated
01/21/2009
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