Provider Demographics
NPI:1508628702
Name:ELIAS, PAIGE (PA-C)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:ELIAS
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 1:1531 S GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5240
Mailing Address - Country:US
Mailing Address - Phone:847-381-8899
Mailing Address - Fax:
Practice Address - Street 1:1531 S GROVE AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5240
Practice Address - Country:US
Practice Address - Phone:847-381-8899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.010289363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant