MEDICARE: STACIA JONES FREUND PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant
2	363A00000X	Physician Assistant	7234	GA

General Provider Information

NPI Number	:	1154738748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACIA JONES FREUND PA

Provider Business Mailing Address
First Line	:	415 W GOLF RD STE 3
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-3923
Country	:	US
Telephone Number	:	847-632-9919
Fax Number	:	847-352-5585

Provider Business Practice Location Address
First Line	:	455 S ROSELLE RD STE 104
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60193-2966
Country	:	US
Telephone Number	:	847-352-5511
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2014
Last Update Date	:	05/29/2026

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