Most Relevant Information
Provider Data
| NPI Number: | 1003478058 |
| Provider Name: | JACQUELINE MARIE GOWAN MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207Q00000X |
| Specialty: | Family Medicine |
| License Number: | 125.073515 |
Most Important Dates
| Enumeration Date: | 06/30/2019 |
| Last Updated: | 06/30/2019 |
Provider Practice Location
1501 S CALIFORNIA AVE STE L1026
CHICAGO
IL
606081732
Practice Location Phone/Fax
| Phone: | 7732576097 |
| Fax: |
Provider Mailing Location
1501 S CALIFORNIA AVE STE L1026
CHICAGO
IL
606081732
Provider Mailing Phone/Fax
| Phone: | 7732576097 |
| Fax: |
Suggested EMR
Family Practice EMR