MS. JESSICA LYNN BOUDOS (NPI# 1265570964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265570964 |
Entity Type | Individual |
Full Name | MS. JESSICA LYNN BOUDOS |
Credential | PAC PHYSICIAN ASSIST |
Practice Address |
680 N Lake Shore Dr #824 Lake Shore Obgyn Chicago IL 60611 |
Practice Telephone | 3129433300 |
Practice Fax Number | 3122664591 |
Mailing Telephone | 3129433300 |
Mailing Fax Number | 3122664591 |
Enumeration Date | 2007-02-02 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
85 002331 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
680 N LAKE SHORE DR #824 LAKE SHORE OBGYN |
City | CHICAGO |
State | IL |
Zip Code | 60611 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427052885 | Jeanette A. Dubay-mcdermit | Nurse Anesthetist, Certified Registered | 680 N Lake Shore Dr, Suite 1000, Chicago, IL 60611-4546 | 2005-06-13 |
1023621406 | Akshar Patel | Student in an Organized Health Care Education/Training Program | 680 N Lake Shore Dr, Tower Apt 720, Chicago, IL 60611 | 2020-08-26 |
1952873267 | Kimberly Sumislawski | Physician Assistant | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2018-12-27 |
1598251571 | Asia Giammarco | Physician Assistant | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2018-07-02 |
1497253256 | Samantha M C Tan | Nurse Practitioner | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2018-01-26 |
1871040642 | Kathleen Dady | Genetic Counselor, MS | 680 N Lake Shore Dr, Suite 1230, Chicago, IL 60611-4546 | 2016-09-08 |
1205382496 | Rachel Green Dunn | Nurse Practitioner | 680 N Lake Shore Dr, Suite 117, Chicago, IL 60611-4546 | 2016-08-29 |
1730634791 | Kelly Elizabeth Smyth | Physician Assistant | 680 N Lake Shore Dr, Chicago, IL 60611 | 2016-08-19 |
1982158036 | Patricia Gale, Md, S.c. | Clinic/Center | 680 N Lake Shore Dr, Suite 930, Chicago, IL 60611-4546 | 2016-08-06 |
1013460930 | Julia Goldin | Registered Nurse | 680 N Lake Shore Dr, Chicago, IL 60611-4546 | 2016-07-27 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
1245854033 | Danielle Humphrey | Student in an Organized Health Care Education/Training Program | Pa Program, Suite 1-200, 240 East Huron Street, Chicago, IL 60611 | 2020-06-08 |
1801418074 | Sana Healing Collective | Clinic/Center | 405 N. Wabash Street, Chicago, IL 60611 | 2020-05-11 |
1194359489 | Insight:eating Disorders, Weight Management & Psychological Centers | Psychiatric Hospital | 1 E. Erie Street, 4th Floor, Chicago, IL 60611 | 2020-02-26 |
1902439193 | Iwona Boska | Nurse Practitioner | 676 N St.clair Street, Suite 2140, Chicago, IL 60611 | 2020-02-17 |
1922643576 | Sarah Elizabeth Schwartzer | Audiologist | Chicago Dizziness and Hearing, 645 North Michigan Avenue, Suite 410, Chicago, IL 60611 | 2019-11-07 |
1023668852 | Anne Marguerite Davidson | Student in an Organized Health Care Education/Training Program | Mcgraw Medical Center, 240 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2019-09-13 |
1871141085 | Coast Management | Durable Medical Equipment & Medical Supplies | 40 E. Chicago Ave, Suite 149, Chicago, IL 60611 | 2019-08-30 |
Find all providers in zip 60611 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
1598238883 | Andrea Budzon | Physician Assistant | 2940 N Kimball Ave Apt 2, Chicago, IL 60618-6846 | 2019-01-09 |
1760995161 | Leena Abed Hamdan | Physician Assistant | 251 E Huron St Fl 1, Chicago, IL 60611-2908 | 2017-11-08 |
1134580079 | Joseph Smith II | Physician Assistant | 654 E 84th St, Chicago, IL 60619-5802 | 2016-03-18 |
1679950232 | Alexis Davidman | Physician Assistant | 20 S Clark St Ste, Chicago, IL 60603-1802 | 2015-05-04 |
1669861589 | Stewart David Harsant | Physician Assistant | 1702 N Milwaukee Ave, Chicago, IL 60647-5424 | 2015-01-15 |
1063817013 | Jenna Lynn Sniegowski | Physician Assistant | 675 N Saint Clair St Fl 21, Chicago, IL 60611-5975 | 2014-11-01 |
1851700066 | Lauren Lew | Physician Assistant | 555 West Madison St. Apt 4903, Chicago, IL 60661 | 2014-08-13 |
1306270137 | Brianne Patricia Randall | Physician Assistant | California Blvd. At 15th St., Chicago, IL 60608 | 2013-08-28 |
Find all providers in CHICAGO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.