Most Relevant Information
Provider Data
| NPI Number: | 1003467341 |
| Provider Name: | ERICA RENEE ESCUE PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 085007304 |
Most Important Dates
| Enumeration Date: | 09/27/2019 |
| Last Updated: | 06/27/2024 |
Provider Practice Location
14410 ROUTE 37
JOHNSTON CITY
IL
629513166
Practice Location Phone/Fax
| Phone: | 6189836911 |
| Fax: | 6189836913 |
Provider Mailing Location
PO BOX 155
CHRISTOPHER
IL
628220155
Provider Mailing Phone/Fax
| Phone: | 6187241624 |
| Fax: | 6187244628 |