Provider Demographics
NPI:1023772902
Name:FARBER, CHLOE CHRISTY (PA-C)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:CHRISTY
Last Name:FARBER
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 1:1475 E BELVIDERE RD STE 311
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2016
Mailing Address - Country:US
Mailing Address - Phone:847-535-7657
Mailing Address - Fax:224-271-4600
Practice Address - Street 1:1475 E BELVIDERE RD STE 311
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-2016
Practice Address - Country:US
Practice Address - Phone:847-535-7657
Practice Address - Fax:224-271-4600
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL085-009156363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program