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General NPI Number Information
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NPI Number | 1902816622
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Entity Type | Individual
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Provider Name | JAY CHARLES PARSONS D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 6374 N LINCOLN AVE STE 314
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City | CHICAGO
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State | IL
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Zip | 60659-1283
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Country | US
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Telephone | 773-866-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 6374 N LINCOLN AVE STE 314
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City | CHICAGO
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State | IL
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Zip | 60659-1283
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Country | US
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Telephone | 773-866-9800
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Fax | 773-866-1733
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016-005248
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License Number State | IL
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