Physician Compare National (NPI:1871893859)

HEALTHCARE PROVIDER: ANUJ JAIN M.D

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1871893859
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567603731
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130731000065
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JAIN
	Individual professional last name
Provider First Name	ANUJ
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	6508 S HALSTED ST
	Group Practice or individual's line 1 address
City	CHICAGO
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	606212616
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140103
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST BERNARD HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y