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NPI Code Detail

MEDICARE: HEATHER ANN HOLMES PA-C

MEDICARE: HEATHER ANN HOLMES 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 AssistantPA.0008421CO

General Provider Information

NPI Number : 1750904462
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER ANN HOLMES PA-C
Provider Business Mailing Address
First Line : 333 SKOKIE BLVD STE 108
Second Line :
City : NORTHBROOK
State : IL
Zip : 60062-1623
Country : US
Telephone Number : 847-450-6393
Fax Number : 847-919-8375
Provider Business Practice Location Address
First Line : 333 SKOKIE BLVD STE 108
Second Line :
City : NORTHBROOK
State : IL
Zip : 60062-1623
Country : US
Telephone Number : 847-450-6393
Fax Number : 847-919-8375
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2020
Last Update Date : 01/02/2025

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Directions to “ HEATHER ANN HOLMES PA-C” Practice Location

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