Individual
JOVANA SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11S250 S JACKSON ST STE 102, BURR RIDGE, IL 60527-6887
(630) 451-9503
Mailing address
11S250 S JACKSON ST STE 102, BURR RIDGE, IL 60527-6887
(630) 451-9503
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006772
IL
Other
Enumeration date
10/25/2018
Last updated
12/27/2022
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