NPI 1053620443 · live from the CMS NPI Registry
Abigail Drake, PA-C
Physician Assistant in Skokie, IL. National Provider Identifier 1053620443, active.
NPI record
| NPI | 1053620443 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 4250 Dempster St, Skokie, IL 60076 |
| Practice phone | 847-763-8850 |
| Mailing address | 1030 School Rd, Cambridge, VT 05444 |
| Enumerated | October 2, 2010 |
| Last updated | October 2, 2010 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 085002790 (IL) |
| Physician Assistant | 363A00000X | 3063 (CO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.