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General NPI Number Information
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NPI Number | 1164335840
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Entity Type | Organization
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Legal Business Name | AJ MEDICAL 1, INC
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 1106 N LARKIN AVE UPPR LEVEL
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City | JOLIET
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State | IL
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Zip | 60435-3455
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Country | US
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Telephone | 815-725-6226
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Fax | 815-725-6336
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Provider Business Mailing Address
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Address Line | 447 CREEKSIDE CT
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City | WILLOWBROOK
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State | IL
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Zip | 60527-5492
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Country | US
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Telephone | 248-210-4064
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANAS JABER
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Credential | MD
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Telephone | 248-210-4064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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