Provider Demographics
NPI:1306566369
Name:SWITZER-POPLAR, VERONICA (PA-C)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:SWITZER-POPLAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28910 TURNBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-1835
Mailing Address - Country:US
Mailing Address - Phone:440-223-2734
Mailing Address - Fax:
Practice Address - Street 1:206 S NELTNOR BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-2847
Practice Address - Country:US
Practice Address - Phone:630-206-8024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085010107363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant