VINISE ELACKATTU

LIBERTYVILLE, IL
NPI1922729714
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: IL  085009324)
Additional Taxonomies363A00000X Physician Assistant
(Licence: IL  085009324)
Enumeration Date2022-09-08
Last Update Date2025-04-22
Business Address
VINISE ELACKATTU PA
716 S MILWAUKEE AVE
LIBERTYVILLE, IL 60048-3225
Phone number: 847-362-1848
Mailing Address
VINISE ELACKATTU PA
29373 NETWORK PL
CHICAGO, IL 60673-1293
Phone number: