Provider Demographics
NPI:1497284673
Name:LENART, ANDREW THEOPHILUS (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:THEOPHILUS
Last Name:LENART
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1860 PAYSPHERE CIR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-0018
Mailing Address - Country:US
Mailing Address - Phone:306-469-9200
Mailing Address - Fax:630-717-2621
Practice Address - Street 1:3825 HIGHLAND AVE STE 210
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1561
Practice Address - Country:US
Practice Address - Phone:630-435-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2022-06-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL085.006197363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant