Provider Demographics
NPI:1457825481
Name:WORTHINGTON, ASHLEY ANN
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:WORTHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N MICHIGAN AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7605
Mailing Address - Country:US
Mailing Address - Phone:312-263-4625
Mailing Address - Fax:312-263-5029
Practice Address - Street 1:150 N MICHIGAN AVE STE 1200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7605
Practice Address - Country:US
Practice Address - Phone:312-263-4625
Practice Address - Fax:312-263-5029
Is Sole Proprietor?:No
Enumeration Date:2019-01-12
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant