Healthcare Provider Details

I. General information

NPI: 1306891676
Provider Name (Legal Business Name): JORY A. NATKIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 PFINGSTEN RD STE 200
GLENVIEW IL
60026-1373
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-998-4100
  • Fax: 847-998-1419
Mailing address:
  • Phone: 847-570-2040
  • Fax: 847-570-5315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036075701
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: