Individual provider · Type 1 NPI

Jessica Lynn Boudos, PAC PHYSICIAN ASSIST

Medical Physician Assistant · Chicago, IL

NPI number 1265570964 Active

Practice location

680 N Lake Shore Dr, #824 Lake Shore Obgyn
Chicago, IL 60611

Fax (312) 266-4591

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X85 002331 (IL)

Medical Physician Assistant: Definition to come...

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About NPI 1265570964

Jessica Lynn Boudos, PAC PHYSICIAN ASSIST's National Provider Identifier is 1265570964, issued on Feb 2, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Chicago, IL. The record was last updated on Dec 17, 2021.