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General NPI Number Information
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NPI Number | 1104515121
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Entity Type | Organization
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Legal Business Name | GERIATRIC CARE NP ASSOCIATES
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Dates
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Enumeration Date | 05/04/2023
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 2515 WAUKEGAN RD PMB 10002
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City | BANNOCKBURN
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State | IL
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Zip | 60015
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Country | US
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Telephone | 847-655-5040
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Fax | 484-218-4920
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Provider Business Mailing Address
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Address Line | 2515 WAUKEGAN RD PMB 10002
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City | BANNOCKBURN
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State | IL
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Zip | 60015
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Country | US
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Telephone | 847-655-5040
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Fax | 484-218-4920
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Authorized Official
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Title or Position | OWNER
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Name | BRITTANY LYNN TOBIN
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Credential | NP
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Telephone | 847-655-5040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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