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General NPI Number Information
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NPI Number | 1710206545
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Entity Type | Individual
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Provider Name | NEIL JARIWALA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-216-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1007 MANSELL RD # A-123
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City | ROSWELL
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State | GA
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Zip | 30076-5019
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Country | US
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Telephone | 678-200-0048
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD61530051
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01073907A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 076851
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036160850
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License Number State | IL
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