Provider Demographics
NPI:1104456912
Name:KOKASKA, ASHLYNN MARIE
Entity type:Individual
Prefix:
First Name:ASHLYNN
Middle Name:MARIE
Last Name:KOKASKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:3551 HIGHLAND AVE STE 200A
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2100
Practice Address - Country:US
Practice Address - Phone:844-376-3876
Practice Address - Fax:630-929-0633
Is Sole Proprietor?:No
Enumeration Date:2020-01-21
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant