Individual
ELIZA BALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 582-2134
(847) 535-7285
Mailing address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 582-2134
(847) 535-7285
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007728
IL
363AM0700X
Medical Physician Assistant
085.007728
IL
Other
Enumeration date
07/21/2020
Last updated
11/07/2024
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