Most Relevant Information
Provider Data
| NPI Number: | 1003487208 |
| Provider Name: | MATTHEW BRENNER-JEDWABNIK PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 085008342 |
Most Important Dates
| Enumeration Date: | 07/08/2021 |
| Last Updated: | 06/26/2024 |
Provider Practice Location
1801 W TAYLOR ST
CHICAGO
IL
606124795
Practice Location Phone/Fax
| Phone: | 8472076228 |
| Fax: |
Provider Mailing Location
1801 W TAYLOR ST
CHICAGO
IL
606124795
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |