Healthcare Provider Details

I. General information

NPI: 1083400782
Provider Name (Legal Business Name): CLAUDIA ATWOOD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N WESTMORELAND RD # LEVEL1
LAKE FOREST IL
60045-1658
US

IV. Provider business mailing address

1000 N WESTMORELAND RD # LEVEL1
LAKE FOREST IL
60045-1658
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-1800
  • Fax: 847-535-7151
Mailing address:
  • Phone: 312-695-1800
  • Fax: 847-535-7151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085012359
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: