Kaitlin Jensen Bryzinski, PA-C
Physician Assistant, Surgical in Evanston, IL. Individual provider (NPI-1).
NPI number1902178759
StatusActive
Last updated in NPPESJul 9, 2024
Details
- NPI
- 1902178759
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kaitlin Jensen Bryzinski
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 8, 2012
- Certification date
- Jul 9, 2024
- Last updated
- Jul 9, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | 085.004273 | IL | Yes |
| 363A00000X | Physician Assistant | 085.004273 | IL |
Other names
- Kaitlin Jensen (Former Name)
Practice location
2650 Ridge AveWalgreens Building, Suite 3507
Evanston, IL 60201-1718
Phone 847-570-2868
Mailing address
2650 Ridge AveWalgreens Building, Suite 3507
Evanston, IL 60201-1718
Phone 847-570-2868
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