MEDICARE: KARLA J HOLTZMAN 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
1	363AM0700X	Medical Physician Assistant	085.001217	IL

General Provider Information

NPI Number	:	1851544936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA J HOLTZMAN PA

Provider Business Mailing Address
First Line	:	2272 95TH ST STE 325
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-8944
Country	:	US
Telephone Number	:	630-778-4700
Fax Number	:	630-778-4755

Provider Business Practice Location Address
First Line	:	2272 95TH ST STE 325
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-8944
Country	:	US
Telephone Number	:	630-778-4700
Fax Number	:	630-778-4755

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	05/13/2019

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