Healthcare Provider Details

I. General information

NPI: 1528484094
Provider Name (Legal Business Name): RASHINA JANAI BOWDEN PA-C, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2014
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 S HIGHLAND AVE STE 220
LOMBARD IL
60148-4932
US

IV. Provider business mailing address

PO BOX 713260
CHICAGO IL
60677-1260
US

V. Phone/Fax

Practice location:
  • Phone: 630-790-1872
  • Fax: 630-873-8812
Mailing address:
  • Phone: 630-469-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085.004994
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number096002530
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: