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1386228799
SAMANTHA NICHOLE LAYSTROM
SKOKIE, IL
NPI
1386228799
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Former Name
SAMANTHA NICHOLE RODRIGUEZ
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085008351)
Enumeration Date
2021-05-11
Last Update Date
2024-03-11
Business Address
MRS. SAMANTHA NICHOLE LAYSTROM PA-C
9600 GROSS POINT RD
SKOKIE, IL 60076-1214
Phone number: 847-677-9600
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Mailing Address
MRS. SAMANTHA NICHOLE LAYSTROM PA-C
1235 S WHITE OAK DR APT 1635
WAUKEGAN, IL 60085-8358
Phone number: 478-301-9958
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