MEDICARE: MS. MARIA JULIANNA ASTACIO P.A.-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
1	363AM0700X	Medical Physician Assistant	085-002516	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	085-002516	OTHER	IL	STATE PROVIDER LICENCE

General Provider Information

NPI Number	:	1508073198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA JULIANNA ASTACIO P.A.-C

Provider Business Mailing Address
First Line	:	36W649 WINDING TRL
Second Line	:
City	:	WEST DUNDEE
State	:	IL
Zip	:	60118-9350
Country	:	US
Telephone Number	:	224-558-5493
Fax Number	:	224-220-0840

Provider Business Practice Location Address
First Line	:	1140 N MCLEAN BLVD STE I
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60123-1782
Country	:	US
Telephone Number	:	224-523-8971
Fax Number	:	224-220-0840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	05/26/2026

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