Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 308244 | LA |
N | 111NI0900X | Internist | 308244 | LA |
N | 207RG0300X | Geriatric Medicine | 308244 | LA |
Y | 207RS0012X | Sleep Medicine | 036.149124 | IL |
NPI | 1033559851 |
---|---|
Provider Name | Jeremy Wearn |
First Address | Burr Ridge, IL 60527-6686 |
Second Address | Chicago, IL 60637-1443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2013 |
Last Update Date | 03/05/2019 |