Individual provider · Type 1 NPI

Larisa G. Basa

Family Nurse Practitioner · Park Ridge, IL

NPI number 1336884493 Active

Practice location

1675 W Dempster St
Park Ridge, IL 60068-1110

Mailing address

29373 Network Pl
Chicago, IL 60673-2926

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X209.024855 (IL)

Family Nurse Practitioner: Definition to come...

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About NPI 1336884493

Larisa G. Basa's National Provider Identifier is 1336884493, issued on May 3, 2022. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Park Ridge, IL. The record was last updated on Dec 22, 2022.