Individual
DANIELA CVETKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
915 S WAUKEGAN RD, LAKE FOREST, IL 60045-2654
(847) 234-8866
(847) 234-4682
Mailing address
915 S WAUKEGAN RD, LAKE FOREST, IL 60045-2654
(847) 234-8866
(847) 234-4682
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
363A00000X
Physician Assistant
Primary
085005467
IL
363AM0700X
Medical Physician Assistant
085005467
IL
Other
Enumeration date
03/02/2012
Last updated
08/30/2022
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