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General NPI Number Information
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NPI Number | 1972559615
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Entity Type | Individual
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Provider Name | JEFFREY NATHANSON MD
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Gender | Male
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 40 SKOKIE BLVD SUITE 110
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City | NORTHBROOK
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State | IL
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Zip | 60062-1614
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Country | US
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Telephone | 224-407-4400
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Fax | 224-407-2255
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Provider Business Mailing Address
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Address Line | 950 TECHNOLOGY WAY SUITE 250
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-5366
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Country | US
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Telephone | 224-407-4400
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Fax | 224-407-2255
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036105275
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License Number State | IL
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