Provider Demographics
NPI:1881193001
Name:GAMEZ, JOCELIN (PA-C)
Entity Type:Individual
Prefix:
First Name:JOCELIN
Middle Name:
Last Name:GAMEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 N MICHIGAN AVE STE 1605
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7478
Mailing Address - Country:US
Mailing Address - Phone:312-994-3000
Mailing Address - Fax:312-201-1202
Practice Address - Street 1:180 N MICHIGAN AVE STE 1605
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7478
Practice Address - Country:US
Practice Address - Phone:312-994-3000
Practice Address - Fax:312-201-1202
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.006491207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine