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Individual

MRS. JASMINE NICOLE-CHURCHILL MATTHEWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
251 E HURON ST STE 5-704, CHICAGO, IL 60611-2908
(312) 695-0061
(312) 695-9013
Mailing address
251 E HURON ST STE 5-704, CHICAGO, IL 60611-2908
(312) 695-0061
(312) 695-9013

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007227
IL
363AS0400X
Surgical Physician Assistant
PA030922
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
297256ZBPZ
DC
Enumeration date
02/26/2013
Last updated
10/11/2022
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