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NPI 1912478074

NPI 1912478074 : ERIN KANE PA-C : WINFIELD, IL

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General NPI Number Information
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    NPI Number           |    1912478074
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    Entity Type          |    Individual 
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    Provider Name        |    ERIN KANE PA-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/16/2018
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    Last Update Date     |    12/10/2025
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Provider Practice Location Address
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    Address Line         |    25 N WINFIELD RD STE 2022 
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    City                 |    WINFIELD
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    State                |    IL
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    Zip                  |    60190-1379
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    Country              |    US
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    Telephone            |    630-352-5450
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    Fax                  |    630-352-4320
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Provider Business Mailing Address
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    Address Line         |    2650 RIDGE AVE STE 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            |    847-570-2040
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    085006948
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    License Number State |    IL
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Taxonomy #2
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    Taxonomy Code        |    363AS0400X
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    Taxonomy Name        |    Surgical Physician Assistant
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    License Number       |    085006948
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    License Number State |    IL
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