Jeremy Larva is a Physician Assistant in Chicago, Illinois. Jeremy Larva practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Jeremy Larva is 1003021916. The last update date is 2017-08-03.
Jeremy Larva's current location address is 259 E Erie St Fl 13, Chicago, Illinois. You can contact this provider via phone number 3126956800 and fax number 3126952772. The mailing address for Jeremy Larva is 259 E Erie St Fl 13, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeremy Larva |
|---|---|
| Address | 259 E Erie St Fl 13, Chicago, Illinois |
| Phone Number | 3126956800 |
| Fax Number | 3126952772 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1003021916 |
|---|---|
| Provider Enumeration Date | 2007-05-14 |
| Last Updated Date | 2017-08-03 |
Provider Mailing Address Detail
| Address | 259 E Erie St Fl 13 |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606113926 |
| Phone Number | 3126956800 |
| Fax Number | 3126952772 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 85006107 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the unique identifier code issued to Jeremy Larva by the Centers for Medicare & Medicaid Services?
The Jeremy Larva has been assigned the NPI (National Provider Identifier) 1003021916. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Jeremy Larva?
The Jeremy Larva is situated at 259 E Erie St Fl 13, in the city of Chicago, state of IL, with the zip code 606113926.
What is Jeremy Larva's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jeremy Larva's specialized field of practice is Physician Assistant, and the corresponding taxonomy code that categorizes this area of specialization is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1003021916 to Jeremy Larva?
The Jeremy Larva received its 1003021916 assignment from the Centers for Medicare & Medicaid Services on 2007-05-14.
As of what date was the information regarding Jeremy Larva, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jeremy Larva, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2017-08-03.
NPI Number: 1982607784
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