Healthcare Provider Details

I. General information

NPI: 1063630895
Provider Name (Legal Business Name): ERICA C ATTANASIO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERICA C BROWN DO

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N ADDISON AVE
ELMHURST IL
60126-2857
US

IV. Provider business mailing address

PO BOX 713260
CHICAGO IL
60677-1260
US

V. Phone/Fax

Practice location:
  • Phone: 630-832-3100
  • Fax: 630-832-1604
Mailing address:
  • Phone: 630-469-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036116784
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: