Individual
MISS IZABELA AGNIESZKA HOLANDAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
25 NORTH WINFIELD ROAD, WINFIELD, IL 60190-1295
(630) 933-4257
(630) 933-4520
Mailing address
25 N WINFIELD RD., WINFIELD, IL 60190-1295
(630) 933-4257
(630) 933-4520
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005050
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400144739
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
05/13/2014
Last updated
10/10/2018
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