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Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Adult Health

Provider NPI: 1720534316

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
Tel: 847-931-8900  Fax: 847-931-9041

Business Mailing Address:
750 FLETCHER DR STE 200  ELGIN, IL 60123-4703 US
Tel: 847-931-8900  Fax: 847-931-9041

NPI Information:
NPI: 1720534316
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y363LA2200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Adult Health
N363LA2200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 363LA2200X





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