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General NPI Number Information
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NPI Number | 1053373274
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Entity Type | Individual
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Provider Name | JEFFREY M PALACIOS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 1642 W COLONIAL PKWY
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City | INVERNESS
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State | IL
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Zip | 60067-4725
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Country | US
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Telephone | 847-749-0514
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Fax | 847-221-8040
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Provider Business Mailing Address
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Address Line | 351 DUBLIN RD
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-3514
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Country | US
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Telephone | 617-775-5340
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 213034
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License Number State | MA
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