Healthcare Provider Details

I. General information

NPI: 1306000765
Provider Name (Legal Business Name): TRISHA L ATKINS P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 06/29/2020
Certification Date: 06/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 N AIRLITE ST
ELGIN IL
60123-4912
US

IV. Provider business mailing address

1 TRANSAM PLAZA DR SUITE 360
OAKBROOK TERRACE IL
60181-4822
US

V. Phone/Fax

Practice location:
  • Phone: 847-695-3200
  • Fax:
Mailing address:
  • Phone: 630-785-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: