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Individual

ASHLEY MARIE MENICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(812) 639-9927
Mailing address
501 SKOKIE BLVD FL 2, NORTHBROOK, IL 60062-2802
(812) 639-9927

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
Primary
085-006879
IL

Other

Enumeration date
10/11/2018
Last updated
07/03/2024
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