Provider Demographics
NPI:1538498100
Name:KAUFMAN, CARMEN JEAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:JEAN
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CARMEN
Other - Middle Name:JEAN
Other - Last Name:COAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2088 OGDEN AVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4376
Mailing Address - Country:US
Mailing Address - Phone:630-851-6440
Mailing Address - Fax:630-851-7001
Practice Address - Street 1:2088 OGDEN AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4376
Practice Address - Country:US
Practice Address - Phone:630-851-6440
Practice Address - Fax:630-851-7001
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085002828363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical