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General NPI Number Information
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NPI Number | 1255330361
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Entity Type | Individual
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Provider Name | DINESH K JAIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 17148 HARLEM AVE
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City | TINLEY PARK
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State | IL
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Zip | 60477-3331
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Country | US
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Telephone | 708-429-1200
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Fax | 708-429-4845
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Provider Business Mailing Address
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Address Line | POB 7132960
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City | CHICAGO
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State | IL
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Zip | 60677-0001
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Country | US
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Telephone | 630-469-9200
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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 | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 036067930
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 036067930
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036-067930
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License Number State | IL
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