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Individual
JONATHAN WILLIAM JANSEN
Active
Individual
JONATHAN WILLIAM JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036136259
IL
208M00000X
Hospitalist Physician
Primary
036136259
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036136259
—
IL
01
—
206147
MEDICARE GROUP
IL
01
—
F400262423
MEDICARE PTAN
IL
Enumeration date
04/06/2009
Last updated
05/24/2023
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