Provider Demographics
NPI:1477701357
Name:BOROWICZ, JESSICA LANE (DO)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LANE
Last Name:BOROWICZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:LANE
Other - Last Name:FLOWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:2601 COMPASS RD
Practice Address - Street 2:STE 125
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8077
Practice Address - Country:US
Practice Address - Phone:847-843-3376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10469207N00000X
CA20A 11725207N00000X
IL036.128711207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology