Individual
MRS. ANNETTE FACINELLI BOBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3471 GREEN BAY RD, NORTH CHICAGO, IL 60064-3090
(847) 473-4357
(847) 578-3269
Mailing address
PO BOX 610, NORTH CHICAGO, IL 60064-0610
(847) 578-8767
(847) 578-8671
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000395
IL
Other
Enumeration date
03/16/2011
Last updated
03/16/2011
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