Individual
DR. JONATHAN WAXMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2000 OGDEN AVE, AURORA, IL 60504-5893
(630) 499-2404
(630) 499-4750
Mailing address
2715 WENDY DR, NAPERVILLE, IL 60565-5316
(561) 400-6206
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
38951
TN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME99916
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02021708
—
MS
05
—
024508200
—
FL
05
—
09016196
—
MS
05
—
159651001
—
AR
05
—
209347905
—
MO
05
—
3339325
—
TN
05
—
3713059
—
TN
01
—
4095320
INDIVID #
TN
01
—
62-1719735
TAX ID
TN
01
—
8P057
GRP #
AR
01
—
99676
INDIVID #
AR
Enumeration date
06/21/2006
Last updated
06/11/2025
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