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Larisa G Basa
Family Nurse Practitioner in Park Ridge, Illinois
NPI 1336884493

Larisa G Basa is a Family Nurse Practitioner based in Chicago, IL and is specialized in Family. Larisa G Basa practices in Park Ridge, IL. The NPI Number for Larisa G Basa is 1336884493 and holds a License No. 209.024855 (Illinois).

The current practice location address for Larisa G Basa is 1675 W Dempster St, Park Ridge, IL and can be reached out via phone at 847-723-9470.

Location: 1675 W Dempster St, Park Ridge, IL, 60673-2926
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336884493
Provider Name
Larisa G Basa
Credential
Provider Entity Type
Individual
Gender
Female
Address
1675 W Dempster St, Park Ridge, IL, 60673-2926
Phone Number
847-723-9470
Fax Number
Provider Enumeration Date
05/03/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1675 W Dempster St
City
Park Ridge
State
Illinois
Zip
60068-1110
Phone Number
847-723-9470
Fax Number
person
Provider Business Mailing Address Details
Address
1675 W Dempster St
City
Park Ridge
State
Illinois
Zip
60068-1110
Phone Number
847-723-9470
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
209.024855 (Illinois)
Definition
Definition to come...
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