Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JASON D CHURCHILL, PA
ActiveMedical Physician Assistant · ELDORADO, IL
Registration Details
- NPI Number
- 1265592455
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 11, 2006 (19.361236797245 yrs)
- Last Updated
- Feb 14, 2019
- Licenses
-
2006030653 (MO)085-002808 (IL)
Practice Information
- Address
-
1306 MAPLE STELDORADO, IL, 629301662Browse IL providers · Browse ZIP 62930
- Phone
- 6182733361
- Fax
- 6182732504
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
- Additional Specialty
- Medical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.