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General NPI Number Information
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NPI Number | 1790950665
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Entity Type | Organization
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Legal Business Name | JNN INTERNAL MEDICINE, SC
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 1703 LUNT AVE
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City | DES PLAINES
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State | IL
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Zip | 60018-3838
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Country | US
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Telephone | 224-522-9945
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Fax | 847-316-4322
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Provider Business Mailing Address
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Address Line | 1703 LUNT AVE
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City | DES PLAINES
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State | IL
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Zip | 60018-3838
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Country | US
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Telephone | 224-522-9945
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Fax | 847-316-4322
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUNITHA NAIR
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Credential | MD
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Telephone | 224-522-9945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 036108897
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License Number State | IL
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