Individual
JACK JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
207 S JACKSON ST, GARDNER, IL 60424-6194
(815) 822-7841
Mailing address
207 S JACKSON ST, GARDNER, IL 60424-6194
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1249459
IL
Other
Enumeration date
07/29/2026
Last updated
07/29/2026
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