Individual
JENNA ASHLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3204
(847) 362-2900
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-3204
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085010571
IL
Other
Enumeration date
06/11/2024
Last updated
10/18/2024
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