Individual
VALERIE M WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
188 W INDUSTRIAL DR, ELMHURST, IL 60126-1623
(630) 410-9888
(630) 941-8194
Mailing address
188 W INDUSTRIAL DR, ELMHURST, IL 60126-1623
(630) 410-9888
(630) 941-8194
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085002800
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08500280
LICENSE
IL
01
—
CE9335
RR GROUP NUMBER
IL
01
—
P00345216
RR MEDICARE NUMBER
IL
Enumeration date
09/12/2006
Last updated
12/08/2014
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