MEDICARE: YOGESH JAIN

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	2251X0800X	Orthopedic Physical Therapist	070.021266	IL

General Provider Information

NPI Number	:	1962895060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOGESH JAIN

Provider Business Mailing Address
First Line	:	2901 S KING DR APT 1002
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-3393
Country	:	US
Telephone Number	:	412-273-8001
Fax Number	:

Provider Business Practice Location Address
First Line	:	4907 W 95TH ST
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-2503
Country	:	US
Telephone Number	:	708-422-3300
Fax Number	:

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

Provider Enumeration Date	:	03/12/2015
Last Update Date	:	03/12/2015

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Directions to “ YOGESH JAIN ” Practice Location

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