1528234234 NPI number — DR. CATHERINE ANNE JASELSKIS DO

Table of content: DR. CATHERINE ANNE JASELSKIS DO (NPI 1528234234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528234234 NPI number — DR. CATHERINE ANNE JASELSKIS DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JASELSKIS
Provider First Name:
CATHERINE
Provider Middle Name:
ANNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528234234
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
950 SKOKIE BLVD
Provider Second Line Business Mailing Address:
SUITE 305
Provider Business Mailing Address City Name:
NORTHBROOK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-559-0609
Provider Business Mailing Address Fax Number:
847-559-0629

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
950 SKOKIE BLVD
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
NORTHBROOK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-559-0609
Provider Business Practice Location Address Fax Number:
847-559-0629
Provider Enumeration Date:
05/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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