Provider Demographics
NPI:1710371307
Name:HUNTE, AMY RAE (PA-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:RAE
Last Name:HUNTE
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 1:115 E SOUTH ST
Mailing Address - Street 2:STE F
Mailing Address - City:PLANO
Mailing Address - State:IL
Mailing Address - Zip Code:60545-1595
Mailing Address - Country:US
Mailing Address - Phone:815-354-6777
Mailing Address - Fax:
Practice Address - Street 1:115 E SOUTH ST
Practice Address - Street 2:UNIT F
Practice Address - City:PLANO
Practice Address - State:IL
Practice Address - Zip Code:60545-1417
Practice Address - Country:US
Practice Address - Phone:630-552-7166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-005421363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL085-005421OtherILLINOIS LICENSE