Healthcare Provider Details

I. General information

NPI: 1386208262
Provider Name (Legal Business Name): JESSICA A SPERLING PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA DREWS

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 E ERIE ST FL 13
CHICAGO IL
60611-3926
US

IV. Provider business mailing address

259 E ERIE ST FL 13
CHICAGO IL
60611-3926
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-6800
  • Fax: 312-926-4787
Mailing address:
  • Phone: 312-695-6800
  • Fax: 312-926-4787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number085007681
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085007681
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: