Provider Demographics
NPI:1902256340
Name:POLLAN, ALISON ROSE
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:ROSE
Last Name:POLLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 ACADEMY DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2420
Mailing Address - Country:US
Mailing Address - Phone:847-480-8890
Mailing Address - Fax:212-752-7564
Practice Address - Street 1:605 ACADEMY DR
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2420
Practice Address - Country:US
Practice Address - Phone:847-480-8890
Practice Address - Fax:212-752-7564
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL140.015032235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program