Nicole Marie Locascio, PA-C
Physician Assistant in Libertyville, IL. Individual provider (NPI-1).
NPI number1366073645
StatusActive
Last updated in NPPESAug 30, 2020
Details
- NPI
- 1366073645
- Entity type
- Individual (NPI-1)
- Name
- Miss Nicole Marie Locascio
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 27, 2020
- Certification date
- Aug 30, 2020
- Last updated
- Aug 30, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085007393 | IL | Yes |
| 363A00000X | Physician Assistant | 4976-23 | WI |
Practice location
801 S Milwaukee AveLibertyville, IL 60048-3204
Phone 847-362-2900
Mailing address
111 E Wisconsin Ave Ste 2000Milwaukee, WI 53202-4809
Phone 414-290-6720 · Fax 414-290-6755
Other practice locations
6308 8th Ave
Kenosha, WI 53143-5031
Kenosha, WI 53143-5031
Phone 262-656-2011
9555 76th St
Pleasant Prairie, WI 53158-1984
Pleasant Prairie, WI 53158-1984
Phone 262-577-8000
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