Provider Demographics
NPI:1508020983
Name:OLSEN, ERIN PATRICK (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:PATRICK
Last Name:OLSEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:PATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1550 N. NORTHWEST HWY.
Mailing Address - Street 2:SUITE 211
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068
Mailing Address - Country:US
Mailing Address - Phone:847-768-9300
Mailing Address - Fax:847-768-9393
Practice Address - Street 1:1550 N. NORTHWEST HWY.
Practice Address - Street 2:SUITE 211
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:847-768-9300
Practice Address - Fax:847-768-9393
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
IL085003296363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant