Healthcare Provider Details

I. General information

NPI: 1235013665
Provider Name (Legal Business Name): SUBHAH JALIL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 METROHEALTH DR
CLEVELAND OH
44109-1900
US

IV. Provider business mailing address

2500 METROHEALTH DR
CLEVELAND OH
44109-1900
US

V. Phone/Fax

Practice location:
  • Phone: 216-778-7800
  • Fax: 216-778-4494
Mailing address:
  • Phone: 216-778-4494
  • Fax: 216-778-4494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number57.257956
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: