Provider Demographics
NPI:1932110368
Name:TORGERSON, LUCINDA A (PA)
Entity Type:Individual
Prefix:MS
First Name:LUCINDA
Middle Name:A
Last Name:TORGERSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1721 MOON LAKE BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1069
Mailing Address - Country:US
Mailing Address - Phone:847-519-3651
Mailing Address - Fax:847-519-3652
Practice Address - Street 1:1721 MOON LAKE BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1069
Practice Address - Country:US
Practice Address - Phone:847-519-3651
Practice Address - Fax:847-519-3652
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085002592363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL085002592OtherLICENSE
IL085002592OtherLICENSE
ILK29586Medicare PIN