Basic Information
| Provider Information | |||||||||
| NPI: | 1932110368 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TORGERSON | ||||||||
| FirstName: | LUCINDA | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1721 MOON LAKE BLVD | ||||||||
| Address2: | STE 150 | ||||||||
| City: | HOFFMAN ESTATES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601691069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475193651 | ||||||||
| FaxNumber: | 8475193652 | ||||||||
| Practice Location | |||||||||
| Address1: | 1721 MOON LAKE BLVD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | HOFFMAN ESTATES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601691069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475193651 | ||||||||
| FaxNumber: | 8475193652 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2006 | ||||||||
| LastUpdateDate: | 02/27/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 085002592 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 085002592 | 01 | IL | LICENSE | OTHER |