Healthcare Provider Details

I. General information

NPI: 1134023187
Provider Name (Legal Business Name): TRISHA ELIZABETH ABU PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

3410 RIVER FALLS DR
NORTHBROOK IL
60062-5044
US

IV. Provider business mailing address

3410 RIVER FALLS DR
NORTHBROOK IL
60062-5044
US

V. Phone/Fax

Practice location:
  • Phone: 734-658-3827
  • Fax:
Mailing address:
  • Phone: 734-658-3827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: