Provider Demographics
NPI:1306899810
Name:FERGUSON, ALISON BROWN (PT)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:BROWN
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2142
Mailing Address - Country:US
Mailing Address - Phone:630-832-6919
Mailing Address - Fax:630-832-6928
Practice Address - Street 1:77 W WACKER DR
Practice Address - Street 2:MEZZANINE 3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-1604
Practice Address - Country:US
Practice Address - Phone:312-201-0467
Practice Address - Fax:312-201-0469
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist