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General NPI Number Information
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NPI Number | 1346375177
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Entity Type | Individual
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Provider Name | JEFFREY JAMESON
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Gender | Male
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 811 W EVERGREEN AVE STE 404
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City | CHICAGO
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State | IL
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Zip | 60642-7113
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Country | US
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Telephone | 312-242-1665
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Fax |
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Provider Business Mailing Address
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Address Line | 4651 N GREENVIEW AVE APT 410
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City | CHICAGO
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State | IL
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Zip | 60640-7944
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Country | US
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Telephone | 312-860-8846
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC009084
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 116050
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056010804
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License Number State | IL
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