Individual
JAISON PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8201 E RIVERSIDE BLVD, ROCKFORD, IL 61114-2300
(815) 971-7000
Mailing address
7702 N ALPINE RD, LOVES PARK, IL 61111-3107
(815) 971-3397
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.085838
IL
Other
Enumeration date
05/22/2025
Last updated
05/22/2025
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