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General NPI Number Information
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NPI Number | 1962895060
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Entity Type | Individual
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Provider Name | YOGESH JAIN
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Gender | Male
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 03/12/2015
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Provider Practice Location Address
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Address Line | 4907 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2503
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Country | US
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Telephone | 708-422-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 S KING DR APT 1002
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City | CHICAGO
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State | IL
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Zip | 60616-3393
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Country | US
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Telephone | 412-273-8001
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 070.021266
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License Number State | IL
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