NPI 1003021916

Jeremy Larva, PAC

Practitioner Physician Assistant Chicago, IL

Practice location

Address: 259 E Erie St Fl 13, Chicago, IL 60611-3926
Phone: (312) 695-6800
Fax: (312) 695-2772
Mailing address: 6269 Karl Rd, Columbus, OH 43229-2128

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 085006107 (IL)

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Registry record

NPI: 1003021916
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 May 2007
Record last updated: 3 Aug 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.