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JESSICA BASTIDAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
5215 N CALIFORNIA AVE STE F801, CHICAGO, IL 60625-7014
(847) 503-3000
(847) 503-3500
Mailing address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
(847) 982-6715

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.005220
IL
363AS0400X
Surgical Physician Assistant
Primary
085005220
IL

Other

Enumeration date
09/20/2014
Last updated
04/09/2024
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