Dr. Jason Ghodasra
Orthopaedic Hand Surgeon
1870 Silver Cross Blvd Ste 200
New Lenox
, Illinois 60451-8646
Dr. Jason Ghodasra
Orthopaedic Hand Surgeon
1870 Silver Cross Blvd Ste 200
New Lenox
, Illinois 60451-8646
(815) 462-3474
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About
Features
Specialties
- Orthopaedic Hand Surgeon
Languages spoken
- English
Location
First Address
- Dr. Jason Ghodasra
- 1870 Silver Cross Blvd Ste 200
- New Lenox, IL
- Zip : 60451-8646
- Phone : (815) 462-3474
Second Address
- Dr. Jason Ghodasra
- 1870 Silver Cross Blvd Ste 200
- New Lenox, IL
- Zip : 60451-8646
- Fax : (815) 462-1032
- Phone : (815) 462-3474
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XS0106X | Orthopaedic Hand Surgeon | 036150218 | IL |
National Provider Identifier
| NPI | 1316280159 |
|---|---|
| Provider Name | Dr. Jason Ghodasra |
| First Address | New Lenox, IL 60451-8646 |
| Second Address | New Lenox, IL 60451-8646 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/03/2013 |
| Last Update Date | 26/09/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036150218 | ILLINOIS PHYSICIAN AND SURGEON LICENSE (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.