Individual
ALYSSA BOBAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3665 N BROADWAY ST, CHICAGO, IL 60613-4567
(773) 496-4433
Mailing address
1 E SUPERIOR ST STE 306, CHICAGO, IL 60611-2595
(312) 754-9404
(312) 754-9402
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.005660
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
N/A
—
Enumeration date
10/02/2015
Last updated
04/11/2019
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