Individual provider · Type 1 NPI

Courtney Lee Kentala, PA-C

Surgical Physician Assistant · Skokie, IL

NPI number 1811573264 Active

Practice location

9650 Gross Point Rd Ste 2900
Skokie, IL 60076-5006

Call (847) 866-7846 Map

Fax (847) 383-2210

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X085009038 (IL)
Physician Assistant 363A00000X085009038 (IL)

Surgical Physician Assistant: Definition to come...

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About NPI 1811573264

Courtney Lee Kentala, PA-C's National Provider Identifier is 1811573264, issued on Mar 23, 2021. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Skokie, IL. The record was last updated on Mar 19, 2026.