JACOB PARK

CHICAGO, IL
NPI1528463346
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  85-005291)
Enumeration Date2014-10-23
Last Update Date2024-02-24
Business Address
JACOB PARK PA-C
1740 W TAYLOR ST RM 724W
CHICAGO, IL 60612-7232
Phone number: 402-314-8567
Mailing Address
JACOB PARK PA-C
1740 W TAYLOR ST RM 724W
CHICAGO, IL 60612-7232
Phone number: 402-314-8567
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