Provider Demographics
NPI:1205453891
Name:LOBRACO, SAMANTHA (PA-C)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:LOBRACO
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Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:1531 S GROVE AVE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5250
Mailing Address - Country:US
Mailing Address - Phone:847-381-8899
Mailing Address - Fax:847-381-8999
Practice Address - Street 1:85 W ALGONQUIN RD STE 220
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4423
Practice Address - Country:US
Practice Address - Phone:847-381-8899
Practice Address - Fax:847-381-8999
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL085.007791363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant