MEDICARE: DR. JALAL RAIS DANA MD

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
1	208000000X	Pediatrics Physician	36 090842	IL

General Provider Information

NPI Number	:	1952414708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JALAL RAIS DANA MD

Provider Business Mailing Address
First Line	:	9655 WOODS DR UNIT 1801
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-4434
Country	:	US
Telephone Number	:	773-348-6530
Fax Number	:	773-348-6531

Provider Business Practice Location Address
First Line	:	7107 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60634-4688
Country	:	US
Telephone Number	:	773-348-6530
Fax Number	:	773-348-6531

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	07/02/2025

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