Individual provider Active NPI

Alison Rose Pollan

  • Speech-Language Pathologist
  • Northbrook, IL
National Provider Identifier
1902256340
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
140.015032 Issued in IL
Practice address
605 Academy Dr
Northbrook, IL 60062-2420
Phone
(847) 480-8890
Fax
(212) 752-7564
NPI assigned
Jun 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Speech-Language Pathologist 235Z00000X 140.015032 IL Primary

Addresses

Primary practice location

605 Academy Dr
Northbrook, IL 60062-2420

Mailing address

605 Academy Dr
Northbrook, IL 60062-2420
Phone (847) 480-8890

Other practice location 1

51A E 117th St
New York, NY 10035-4514
Phone (212) 289-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
140.015032ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1902256340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 ACADEMY DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622420",
            "telephone_number": "847-480-8890",
            "fax_number": "212-752-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 ACADEMY DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622420",
            "telephone_number": "847-480-8890",
            "fax_number": "212-752-7564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51A E 117th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100354514",
            "country_code": "US",
            "telephone_number": "212-289-6100",
            "fax_number": "212-289-6779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLAN",
        "first_name": "ALISON",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "140.015032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.