Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 036-105263 | IL |
NPI | 1386637874 |
---|---|
Provider Name | Dr. Deepak Jajoo |
First Address | Chicago, IL 60674-0035 |
Second Address | Chicago, IL 60608-1732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 06/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036-105263-1 | (05) | IL |
H78282 | (02) | IL |