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Search › Illinois › 363A00000X

Amanda Fraser, PA-C

NPI 1609619691 · on the registry since 2024 · sole proprietor

Practice

Address
1100 Broadway
Rockford, IL 61104
Phone
(815) 490-1600
Organisation at this address
Walgreen Co
Laboratory Corporation Of America
Crusaders Central Clinic Association
Crusaders Central Clinic Association
Inferred from a shared address, not stated in the registry.
Clinicians at this address
5

Registry record

Primary taxonomy
363A00000X
363A00000X
Also registered as
363A00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-10-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois