MEDICARE: DR. JAY CHARLES PARSONS D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	016-005248	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00307283	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0001623503	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1902816622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY CHARLES PARSONS D.P.M.

Provider Business Mailing Address
First Line	:	6374 N LINCOLN AVE STE 314
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-1283
Country	:	US
Telephone Number	:	773-866-9800
Fax Number	:	773-866-1733

Provider Business Practice Location Address
First Line	:	6374 N LINCOLN AVE STE 314
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-1283
Country	:	US
Telephone Number	:	773-866-9800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	07/17/2008

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Directions to “ DR. JAY CHARLES PARSONS D.P.M.” Practice Location

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