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NPI Code Detail

MEDICARE: MORGAN ELIZABETH HOLT PA-C

MEDICARE: MORGAN ELIZABETH HOLT PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant085005024IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11633878OTHERILBCBS IL

General Provider Information

NPI Number : 1437575362
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN ELIZABETH HOLT PA-C
Provider Business Mailing Address
First Line : PO BOX 735263
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5263
Country : US
Telephone Number : 877-632-6637
Fax Number : 708-409-5179
Provider Business Practice Location Address
First Line : 55 SHUMAN BLVD STE 700
Second Line :
City : NAPERVILLE
State : IL
Zip : 60563-8422
Country : US
Telephone Number : 877-632-6637
Fax Number : 708-409-5179
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2014
Last Update Date : 04/19/2024

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Directions to “ MORGAN ELIZABETH HOLT PA-C” Practice Location

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