Provider Demographics
NPI:1477749430
Name:BARUFFI, ELIZABETH K (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:K
Last Name:BARUFFI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 MINTHAVEN CT
Mailing Address - Street 2:APT #7D220
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3926
Mailing Address - Country:US
Mailing Address - Phone:847-293-4965
Mailing Address - Fax:
Practice Address - Street 1:1800 HOLLISTER DR
Practice Address - Street 2:SUITE 102
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5263
Practice Address - Country:US
Practice Address - Phone:847-680-3666
Practice Address - Fax:847-680-3994
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-23
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.003018363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant