Provider Demographics
NPI:1720522188
Name:SEARS, NAOMI (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:
Last Name:SEARS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:BERKOWITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:2650 RIDGE AVE STE 1223
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1700
Mailing Address - Country:US
Mailing Address - Phone:847-982-6710
Mailing Address - Fax:
Practice Address - Street 1:5140 N CALIFORNIA AVE STE 740
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-7066
Practice Address - Country:US
Practice Address - Phone:773-293-4170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020470363A00000X
IL085008564363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant