Individual
JAKE MUSASHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1725 W HARRISON ST STE 970, CHICAGO, IL 60612-3828
(312) 563-3447
Mailing address
1725 W HARRISON ST STE 970, CHICAGO, IL 60612-3828
(312) 563-3447
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006426
IL
Other
Enumeration date
11/08/2017
Last updated
04/12/2021
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