Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 036090608 | IL |
NPI | 1053331074 |
---|---|
Provider Name | Joseph Thomas Alleva |
First Address | Glenview, IL 60026-1339 |
Second Address | Glenview, IL 60026-1339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 01/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036090608 | (05) | IL |
1620385 | BLUE SHIELD (01) | IL |
250011789 | RAILROAD MEDICARE (01) | IL |
F83609 | (02) |