Provider Demographics
NPI:1821229501
Name:BORN, JEAN (PA-C)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:BORN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:351 DELNOR DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4220
Mailing Address - Country:US
Mailing Address - Phone:630-232-2885
Mailing Address - Fax:630-232-9936
Practice Address - Street 1:351 DELNOR DR
Practice Address - Street 2:SUITE 400
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4220
Practice Address - Country:US
Practice Address - Phone:630-232-2885
Practice Address - Fax:630-232-9936
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL085001620363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant