Individual
REBECCA F NISHIMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
777 PARK AVE W, HIGHLAND PARK, IL 60035-2433
(847) 926-5844
Mailing address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
(847) 982-6710
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
085002085
IL
363A00000X
Physician Assistant
085002085
IL
363AS0400X
Surgical Physician Assistant
Primary
085002085
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00417652
RAILROAD MCR
—
Enumeration date
08/31/2006
Last updated
03/24/2026
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