Individual
MRS. PAMELA BASAS MALDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
431 W LIBERTY ST, WAUCONDA, IL 60084
(847) 526-2151
(847) 526-2017
Mailing address
PO BOX 6037, WAUCONDA, IL 60084-6037
(847) 526-2151
(847) 526-2017
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209015216
IL
Other
Enumeration date
12/02/2016
Last updated
03/02/2020
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