Healthcare Provider Details

I. General information

NPI: 1669574299
Provider Name (Legal Business Name): JYOTHI JOLEPALEM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SOUTH CALIFORNIA AVE SINAI MEDICAL GROUP DEPT. OF PULMONARY & CRITICAL CARE
CHICAGO IL
60608-1797
US

IV. Provider business mailing address

1500 SOUTH CALIFORNIA AVE SINAI MEDICAL GROUP DEPT. OF PULMONARY CRITICAL CARE
CHICAGO IL
60608-1797
US

V. Phone/Fax

Practice location:
  • Phone: 773-257-4750
  • Fax: 630-910-4020
Mailing address:
  • Phone: 773-257-4750
  • Fax: 630-910-4020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number036089839
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number731
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036089839
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: