Individual
JAMAURI WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5159 S ASHLAND AVE, CHICAGO, IL 60609-4931
(773) 434-9216
Mailing address
2801 THATCHER AVE APT 304, RIVER GROVE, IL 60171-1894
(765) 513-2892
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085010796
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/14/2024
Last updated
11/26/2024
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