Provider Demographics
NPI:1477375715
Name:TESSLER, ALIZA
Entity type:Individual
Prefix:
First Name:ALIZA
Middle Name:
Last Name:TESSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALIZA
Other - Middle Name:
Other - Last Name:KAPLAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3520 W THORNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-4412
Mailing Address - Country:US
Mailing Address - Phone:773-899-1480
Mailing Address - Fax:
Practice Address - Street 1:3145 W PRATT BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-4125
Practice Address - Country:US
Practice Address - Phone:312-357-4691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program