MEDICARE: DR. JASON EDWARD BURNS DN

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	208100000X	Physical Medicine & Rehabilitation Physician		IL

General Provider Information

NPI Number	:	1972618320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON EDWARD BURNS DN

Provider Business Mailing Address
First Line	:	1400 N MILWAUKEE AVE
Second Line	:	#406
City	:	CHICAGO
State	:	IL
Zip	:	60622-5066
Country	:	US
Telephone Number	:	773-457-1757
Fax Number	:

Provider Business Practice Location Address
First Line	:	4337 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-2830
Country	:	US
Telephone Number	:	773-205-6572
Fax Number	:

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

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	07/08/2007

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