Provider Demographics
NPI:1902310030
Name:TOREN, ALYSSA C (CNM)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:C
Last Name:TOREN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 N MILWAUKEE AVE APT 2R
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-4017
Mailing Address - Country:US
Mailing Address - Phone:262-903-8606
Mailing Address - Fax:
Practice Address - Street 1:625 N MICHIGAN AVE STE 210
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3162
Practice Address - Country:US
Practice Address - Phone:312-670-2530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILMO4454176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife