Provider Demographics
NPI:1750057816
Name:DOBOCAN, SIMONA VIOLCA (APN)
Entity Type:Individual
Prefix:MRS
First Name:SIMONA
Middle Name:VIOLCA
Last Name:DOBOCAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 GOLF RD STE 1200
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1200
Mailing Address - Country:US
Mailing Address - Phone:847-563-4488
Mailing Address - Fax:
Practice Address - Street 1:4711 GOLF RD STE 1200
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1200
Practice Address - Country:US
Practice Address - Phone:847-563-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021028363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner