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NPI Code Detail

MEDICARE: MOLLY CATHRYN DELZER PA-C

MEDICARE:   MOLLY CATHRYN DELZER  PA-C
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
1363A00000XPhysician Assistant59266CA
2363A00000XPhysician Assistant085012017IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11172109OTHERNCCPA
259266OTHERCAPHYSICIAN ASSISTANT BOARD

General Provider Information

NPI Number : 1417538745
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY CATHRYN DELZER PA-C
Provider Business Mailing Address
First Line : 2650 RIDGE AVE # 1223
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15 S MCHENRY RD FL 2
Second Line :
City : BUFFALO GROVE
State : IL
Zip : 60089-6705
Country : US
Telephone Number : 847-618-0351
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2021
Last Update Date : 05/01/2026

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Directions to “ MOLLY CATHRYN DELZER PA-C” Practice Location

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