Healthcare Provider Details

I. General information

NPI: 1134992217
Provider Name (Legal Business Name): LINA RIAZ PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 N ARLINGTON HEIGHTS RD
ARLINGTON HEIGHTS IL
60004-4767
US

IV. Provider business mailing address

19700 HERON PASS
BROOKFIELD WI
53045-8140
US

V. Phone/Fax

Practice location:
  • Phone: 847-342-1554
  • Fax:
Mailing address:
  • Phone: 724-579-8753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085.012077
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: