Allen, Andre Lashawn

Allen, Andre Lashawn is an sole proprietor health care provider with primary practice located at 20280 Governors Hwy Ste 206 , Olympia Fields IL 60461-1068. He recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as his primary health care specialty. Allen, Andre Lashawn can be contacted via phone (708) 898-0635.

Contact Information

Primary practice address
20280 Governors Hwy Ste 206 Olympia Fields IL 60461-1068
Phone: (708) 898-0635
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1528713013
LBN Legal business name Allen, Andre Lashawn
Credentials CEO
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 14th, 2022
Last updated Feb 14th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528713013 NPPES
Illinois MEDICAID 3129197649

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