1649290925 NPI number — DR. EILEEN MARIE ALLEN M.D.

Table of content: DR. EILEEN MARIE ALLEN M.D. (NPI 1649290925)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649290925 NPI number — DR. EILEEN MARIE ALLEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLEN
Provider First Name:
EILEEN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649290925
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 FRONT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LISLE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60532-2288
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-493-0994
Provider Business Mailing Address Fax Number:
630-515-0883

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 W CENTRAL RD
Provider Second Line Business Practice Location Address:
NORTHWEST COMMUNITY HOSPITAL
Provider Business Practice Location Address City Name:
ARLINGTON HEIGHTS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60005-2349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-618-3040
Provider Business Practice Location Address Fax Number:
847-618-3049
Provider Enumeration Date:
07/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207PP0204X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)