Provider Demographics
NPI:1871208918
Name:FOWLER, ALLISON CHELSEA (OTR/L)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:CHELSEA
Last Name:FOWLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:CHELSEA
Other - Last Name:SCHIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:629 SCHOOL AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62024-1962
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6301 HUMBERT RD
Practice Address - Street 2:
Practice Address - City:GODFREY
Practice Address - State:IL
Practice Address - Zip Code:62035-2163
Practice Address - Country:US
Practice Address - Phone:618-466-0367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.015295208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation