Individual
JAMIE MULROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
901 MCCLINTOCK DR, STE 202, BURR RIDGE, IL 60527-0872
(888) 220-6432
(630) 734-4715
Mailing address
901 MCCLINTOCK DR, STE 202, BURR RIDGE, IL 60527-0872
(888) 220-6432
(630) 734-4715
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400309221
MEDICARE PTAN
IL
01
—
F400309222
MEDICARE PTAN
IL
01
—
F400309224
MEDICARE PTAN
IL
01
—
F400309226
MEDICARE PTAN
IL
Enumeration date
06/13/2016
Last updated
12/16/2021
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