Provider Demographics
NPI:1861573248
Name:CALL, AMY BETH (PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:CALL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:BETH
Other - Last Name:HOLEWINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5681 N. RIDGE
Mailing Address - Street 2:#2E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660
Mailing Address - Country:US
Mailing Address - Phone:773-989-2211
Mailing Address - Fax:
Practice Address - Street 1:1725 W. HARRISON, PROFESSIONAL BUILDING #3
Practice Address - Street 2:SUITE 774
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-738-3732
Practice Address - Fax:312-738-9763
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP76755Medicare UPIN