Individual
MARYAM MICHELLE BEINTEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
633 EMERSON ST, EVANSTON, IL 60208-0844
(847) 491-8100
(847) 491-5919
Mailing address
633 EMERSON ST, EVANSTON, IL 60208-0844
(847) 491-8100
(847) 491-5919
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085008470
IL
Other
Enumeration date
07/07/2020
Last updated
08/22/2025
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