Provider Demographics
NPI:1972139541
Name:TAYLOR, ALISSA M (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:M
Other - Last Name:TORII
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3879 ANJOU LN
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-1612
Mailing Address - Country:US
Mailing Address - Phone:947-354-0432
Mailing Address - Fax:
Practice Address - Street 1:10225 W HIGGINS RD
Practice Address - Street 2:
Practice Address - City:ROSEMONT
Practice Address - State:IL
Practice Address - Zip Code:60018-3890
Practice Address - Country:US
Practice Address - Phone:847-825-2278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.025027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist