Provider Demographics
NPI:1073848669
Name:TASCH, EMILY CATHERINE (PA - C)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:CATHERINE
Last Name:TASCH
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:CATHERINE
Other - Last Name:ISRAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1331 W 75TH ST STE 303
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-9311
Mailing Address - Country:US
Mailing Address - Phone:630-652-0606
Mailing Address - Fax:630-652-9900
Practice Address - Street 1:1331 W 75TH ST STE 303
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-9311
Practice Address - Country:US
Practice Address - Phone:630-652-0606
Practice Address - Fax:630-652-9900
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085003638363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant