Doctor Name: | MRS. MITA S SASS |
NPI Number: | 1679672133 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | |
Business Practice Address: | 4557 N Osage Ave Norridge, IL - 607064428 |
Business Phone Number: | 7084525277 |
Business Fax Number: | |
Mailing Address: | 4557 N Osage Ave, NORRIDGE |
State: | IL |
Postal Code: | 607064428 |
Phone Number: | 7084525277 |
Fax Number: | |
NPI Enumeration Date: | 09/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |