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NPI Code Detail

MEDICARE: MRS. ERICA JANE TWARLING PA

MEDICARE:  MRS. ERICA JANE TWARLING  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant085-002031IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2214251042OTHERILMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1214249035OTHERILMEICARE

General Provider Information

NPI Number : 1033173356
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ERICA JANE TWARLING PA
Provider Business Mailing Address
First Line : 474 BARN SWALLOW DR
Second Line :
City : LINDENHURST
State : IL
Zip : 60046-4940
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2401 RAVINE WAY
Second Line :
City : GLENVIEW
State : IL
Zip : 60025-7645
Country : US
Telephone Number : 847-998-5680
Fax Number : 847-998-6365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2006
Last Update Date : 06/06/2013

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