Provider Demographics
NPI:1811556871
Name:HOWARD, NATIA N (PA-C)
Entity Type:Individual
Prefix:
First Name:NATIA
Middle Name:N
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7 BLANCHARD CIR STE 104
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-2038
Mailing Address - Country:US
Mailing Address - Phone:630-668-0833
Mailing Address - Fax:630-668-7685
Practice Address - Street 1:7 BLANCHARD CIR STE 104
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-2038
Practice Address - Country:US
Practice Address - Phone:630-668-0833
Practice Address - Fax:630-668-7685
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA095239363A00000X
IL085009475363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant