Individual
JEFFREY JAMESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
811 W EVERGREEN AVE STE 404, CHICAGO, IL 60642-7113
(312) 242-1665
Mailing address
4651 N GREENVIEW AVE APT 410, CHICAGO, IL 60640-7944
(312) 860-8846
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056010804
IL
225X00000X
Occupational Therapist
116050
TX
225X00000X
Occupational Therapist
OC009084
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009941340001
—
PA
Enumeration date
02/22/2007
Last updated
03/09/2017
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