Provider Demographics
NPI:1649831371
Name:RANCICH, MARGARET GRACE (PA-C)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:GRACE
Last Name:RANCICH
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 1:259 E ERIE ST STE 2350
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3370
Mailing Address - Country:US
Mailing Address - Phone:312-926-6000
Mailing Address - Fax:312-926-6323
Practice Address - Street 1:259 E ERIE ST STE 2350
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3370
Practice Address - Country:US
Practice Address - Phone:312-926-6000
Practice Address - Fax:312-926-6323
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
IL085007255363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant