Individual provider Active NPI

Allison Terry, PA-C

  • Surgical Physician Assistant
  • Chicago, IL
National Provider Identifier
1801954490
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085002900 Issued in IL
Practice address
1611 W Harrison St
Ste 400
Chicago, IL 60612-3841
Phone
(312) 243-4244
Fax
(312) 492-5673
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085002900 IL Primary

Addresses

Primary practice location

1611 W Harrison St
Ste 400
Chicago, IL 60612-3841

Mailing address

1 Westbrook Corporate Ctr
#240
Westchester, IL 60154-5701
Phone (708) 236-2673

Other identifiers 2

IdentifierTypeStateIssuer
209118OtherILMEDICARE PTAN LOCALITY 15
209119OtherILMEDICARE PTAN LOCALITY 16

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070108000039 IL Practitioner - Physician Assistant 4981604477 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085002900ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Mar 30, 2020 Accepting new patients

Locations

1700 W Van Buren St
Ste 500
Chicago, IL 60612
Phone (312) 563-2875

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

75 Remittance Dr
Dept 1611
Chicago, IL 60675

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1801954490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WESTBROOK CORPORATE CTR",
            "address_2": "#240",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545701",
            "telephone_number": "708-236-2673",
            "fax_number": "708-492-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "address_2": "STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-243-4244",
            "fax_number": "312-492-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "ALLISON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085002900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN LOCALITY 15",
            "identifier": "209118",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN LOCALITY 16",
            "identifier": "209119",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.