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General NPI Number Information
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NPI Number | 1487231155
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Entity Type | Individual
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Provider Name | IVANA LINA ASENCIO MD
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Gender | Female
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 1200 S YORK ST STE 2000
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City | ELMHURST
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State | IL
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Zip | 60126-5634
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Country | US
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Telephone | 847-982-3175
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Fax | 874-733-5315
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE # 1223
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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Country | US
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Telephone | 847-982-3175
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Fax | 847-733-5315
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036177011
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License Number State | IL
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