Individual
ASHISH JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2050 N MAIN ST STE C, CROWN POINT, IN 46307-2048
(219) 662-3300
(219) 662-3301
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01060449A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200525620
—
IN
01
—
90000854
BCBSIL
IL
Enumeration date
09/23/2005
Last updated
04/27/2023
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