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Organization
ANDRE T DEJEAN /DEJEAN WELLNESS
Active
Organization
ANDRE T DEJEAN /DEJEAN WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDRE T DEJEAN MD (PHYSICIAN)
(773) 620-9864
Entity
Organization
Contact information
Practice address
9040 S MERRILL AVE, CHICAGO, IL 60617-3811
(773) 620-9864
(866) 261-3402
Mailing address
9040 S MERRILL AVE, CHICAGO, IL 60617-3811
(773) 620-9864
(866) 261-3402
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036098449
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098449
—
IL
01
—
1639140700
NPI
IL
Enumeration date
08/02/2009
Last updated
08/02/2009
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