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NPI Code Detail

MEDICARE: DR. JAY HIRSH MAYEFSKY M.D., M.P.H.

MEDICARE: DR. JAY HIRSH MAYEFSKY M.D., M.P.H.
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
1208000000XPediatrics Physician036-069674IL

General Provider Information

NPI Number : 1922055151
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY HIRSH MAYEFSKY M.D., M.P.H.
Provider Business Mailing Address
First Line : 1300 W DEVON AVE
Second Line : HEARTLAND HEALTH CENTERS
City : CHICAGO
State : IL
Zip : 60660-1302
Country : US
Telephone Number : 773-751-7850
Fax Number : 312-751-7855
Provider Business Practice Location Address
First Line : 1300 W DEVON AVE
Second Line : HEARTLAND HEALTH CENTERS
City : CHICAGO
State : IL
Zip : 60660-1302
Country : US
Telephone Number : 773-751-7850
Fax Number : 773-751-7855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 09/09/2016

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