Provider Demographics
NPI:1346671260
Name:JAMESON, MORGAN KAY (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:KAY
Last Name:JAMESON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MORGAN
Other - Middle Name:KAY
Other - Last Name:DE JONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 BIESTERFIELD RD STE 610
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3362
Mailing Address - Country:US
Mailing Address - Phone:847-981-3630
Mailing Address - Fax:
Practice Address - Street 1:800 BIESTERFIELD RD STE 610
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3362
Practice Address - Country:US
Practice Address - Phone:847-981-3630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.004876363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical