Healthcare Provider Details

I. General information

NPI: 1396506432
Provider Name (Legal Business Name): PAIGE YURICK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2024
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E HURON ST STE 801
CHICAGO IL
60611-2912
US

IV. Provider business mailing address

45 NORTHERN BLVD
GREENVALE NY
11548-1346
US

V. Phone/Fax

Practice location:
  • Phone: 312-395-7400
  • Fax:
Mailing address:
  • Phone: 646-350-4023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: