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Individual

THERESE E NASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4405 WEAVER PKWY, WARRENVILLE, IL 60555-3269
(630) 352-5450
(630) 352-5499
Mailing address
4405 WEAVER PKWY, WARRENVILLE, IL 60555-3269
(630) 352-5450
(630) 352-5499

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085002733
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
085002733
ILLINOIS PA LICENSE NO
IL
01
206147
MEDICARE GROUP
IL
01
F400386156
MEDICARE INDIVIDUAL
IL
Enumeration date
01/29/2007
Last updated
03/07/2023
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