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Individual

DR. JAYLA ANN BOSTIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1645 W JACKSON BLVD STE 215, CHICAGO, IL 60612-3227
(312) 942-8028
Mailing address
1645 W JACKSON BLVD STE 215, CHICAGO, IL 60612-3227
(312) 942-8028

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.080091
IL
208000000X
Pediatrics Physician
Primary
125.080091
IL

Other

Enumeration date
05/21/2022
Last updated
05/21/2022
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