Individual
JENNIFER ELISE SOMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 RANDOLPH RD STE 216, CHARLOTTE, NC 28207-1106
(704) 316-5330
(704) 316-5332
Mailing address
901 MCCLINTOCK DR, STE 202, BURR RIDGE, IL 60527-0871
(888) 220-6432
(630) 734-4715
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-13578
NC
363AM0700X
Medical Physician Assistant
085005854
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085-005854
IL LICENSE
IL
Enumeration date
08/19/2016
Last updated
11/02/2023
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