Provider Demographics
NPI:1316321060
Name:HEARN, JENNIFER B (PA-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:B
Last Name:HEARN
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:675 NORTH SAINT CLAIR 18TH FLOOR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4546
Mailing Address - Country:US
Mailing Address - Phone:312-695-8624
Mailing Address - Fax:312-695-6070
Practice Address - Street 1:675 N SAINT CLAIR ST 18TH FLOOR
Practice Address - Street 2:SUITE 250
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-695-8624
Practice Address - Fax:312-695-6070
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2020-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL085.005531363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant