Provider Demographics
NPI:1184630923
Name:FERRO, MARIA TROGRANCIC (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:TROGRANCIC
Last Name:FERRO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:TROGRANCIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1 WESTBROOK CORPORATE CTR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5701
Mailing Address - Country:US
Mailing Address - Phone:312-243-4244
Mailing Address - Fax:312-942-1517
Practice Address - Street 1:1611 W HARRISON ST
Practice Address - Street 2:SUITE 400
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4861
Practice Address - Country:US
Practice Address - Phone:312-243-4244
Practice Address - Fax:312-942-1517
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-002598363AM0700X, 363AS0400X
MDC03815363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00639347OtherRAILROAD MEDICARE
Q75434Medicare UPIN
TRPA81411Medicare PIN
TRPA81421Medicare PIN