Individual provider · Type 1 NPI

Rebecca F. Nishimoto, PA-C

Surgical Physician Assistant · Highland Park, IL

NPI number 1073624664 Active

Practice location

777 Park Ave W
Highland Park, IL 60035-2433

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X085002085 (IL)
Surgical Physician Assistant Primary 363AS0400X085002085 (IL)
Emergency Medicine Physician 207P00000X085002085 (IL)

Surgical Physician Assistant: Definition to come...

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About NPI 1073624664

Rebecca F. Nishimoto, PA-C's National Provider Identifier is 1073624664, issued on Aug 31, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Highland Park, IL. The record was last updated on Mar 24, 2026.