Provider Demographics
NPI:1710369574
Name:HANS, ALLINA MONICA (PT)
Entity type:Individual
Prefix:
First Name:ALLINA
Middle Name:MONICA
Last Name:HANS
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:ALLINA MONICA
Other - Middle Name:VILLEGAS
Other - Last Name:LIAMZON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1920 W POTOMAC AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3149
Mailing Address - Country:US
Mailing Address - Phone:405-821-6648
Mailing Address - Fax:877-349-1138
Practice Address - Street 1:4700 MEMORIAL DR STE 340
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5373
Practice Address - Country:US
Practice Address - Phone:618-234-9884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3443225100000X
IL070025289225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45693027OtherDRIVER'S LICENSE