| Daniel M Provencher, PA-C | |
|
911 N Elm St, Suite 128, Hinsdale, IL 60521-3640 | |
| (630) 789-2260 | |
| (630) 789-1584 |
| Full Name | Daniel M Provencher |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Medical |
| Location | 911 N Elm St, Hinsdale, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053426965 | NPI | - | NPPES |
| 362658747 | Other | IL | FEDERAL TAX ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 085001850 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel M Provencher, PA-C 911 N Elm St, Suite 128, Hinsdale, IL 60521-3640 Ph: (630) 789-2260 | Daniel M Provencher, PA-C 911 N Elm St, Suite 128, Hinsdale, IL 60521-3640 Ph: (630) 789-2260 |
Mary E Mcraven, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 911 N Elm St, Suite 128, Hinsdale, IL 60521 Phone: 630-856-7460 Fax: 630-655-9943 | |
Emily Salvino, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 908 N Elm St Ste 306, Hinsdale, IL 60521 Phone: 630-323-5214 | |
Joseph P Mcdaniel, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 550 W Ogden Ave, Hinsdale, IL 60521 Phone: 630-323-6116 Fax: 630-794-8620 | |
Mr. Faustino Fernandez, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 140 N County Line Rd, Apt 123, Hinsdale, IL 60521 Phone: 630-325-5803 Fax: 630-325-5803 | |
Mrs. Kelly A Burgess, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 550 W Ogden Ave, Hinsdale, IL 60521 Phone: 630-323-6116 Fax: 630-323-5309 | |
Tanja Samardzija, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 40 S Clay St Ste Ll30, Hinsdale, IL 60521 Phone: 630-967-2370 |