Individual
MS. JESSICA LYNN BOUDOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC PHYSICIAN ASSIST
Contact information
Practice address
680 N LAKE SHORE DR, #824 LAKE SHORE OBGYN, CHICAGO, IL 60611
(312) 943-3300
(312) 266-4591
Mailing address
680 N LAKE SHORE DR, #824 LAKE SHORE OBGYN, CHICAGO, IL 60611
(312) 943-3300
(312) 266-4591
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
85 002331
IL
Other
Enumeration date
02/02/2007
Last updated
12/17/2021
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