Individual
JACQUELINE LORRAINE OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2868
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2868
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.010139
IL
363A00000X
Physician Assistant
Primary
085010139
IL
363AS0400X
Surgical Physician Assistant
085010139
IL
Other
Enumeration date
09/07/2022
Last updated
03/24/2026
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