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NPI Code Detail

MEDICARE: HAROLD JAIMES, M.D., S.C.

MEDICARE: HAROLD JAIMES, M.D., S.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11605620OTHERILBLUE SHIELD

General Provider Information

NPI Number : 1487841904
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAROLD JAIMES, M.D., S.C.
Provider Business Mailing Address
First Line : 3153 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2809
Country : US
Telephone Number : 773-395-4600
Fax Number :
Provider Business Practice Location Address
First Line : 3800 HIGHLAND AVE
Second Line : SUITE 111
City : DOWNERS GROVE
State : IL
Zip : 60515-1557
Country : US
Telephone Number : 630-719-4444
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : HAROLD JAIMES
Credential : M.D.
Telephone Number : 773-395-4600
Provider Enumeration Date : 09/28/2007
Last Update Date : 09/28/2007

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