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Contact Information

MARISA BALDASSANO, PA-C
2151 WAUKEGAN RD
BANNOCKBURN, IL60015-1885
 Phone: 847-444-5300
 Fax: 847-267-1429
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MARISA BALDASSANO · (Female)

NPI # 1821392978
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 01/04/2011
Last updated 07/01/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • CO License # PA.0006735
  • IL License # 085010442
  • PA License # MA054617
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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