Individual
JASON MICHAEL VAWTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
240 E HURON ST STE 1-200, CHICAGO, IL 60611-2909
(312) 503-1851
Mailing address
747 52ND ST, OAKLAND, CA 94609-1809
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085009029
IL
363A00000X
Physician Assistant
Primary
PA65890
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2020
Last updated
04/08/2025
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