Provider Demographics
NPI:1154804425
Name:JUREVICIUS, DANIELA (MMS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:DANIELA
Middle Name:
Last Name:JUREVICIUS
Suffix:
Gender:F
Credentials:MMS, PA-C
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Other - First Name:
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Mailing Address - Street 1:10755 163RD PL
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-8861
Mailing Address - Country:US
Mailing Address - Phone:708-873-1187
Mailing Address - Fax:708-364-9307
Practice Address - Street 1:10755 163RD PL
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-8861
Practice Address - Country:US
Practice Address - Phone:708-873-1187
Practice Address - Fax:708-364-9307
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant