Individual
AJIT JEROME AUGUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1725 W HARRISON ST STE 1106, CHICAGO, IL 60612-3845
(312) 563-2114
Mailing address
1725 W HARRISON ST STE 1106, CHICAGO, IL 60612-3845
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
125.079861
IL
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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