Individual
JAMIE TITEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(847) 570-2509
Mailing address
PO BOX 24569, BELFAST, ME 04915-4496
(800) 329-9217
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11332948-1204
UT
208M00000X
Hospitalist Physician
036142520
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2014
Last updated
08/06/2021
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