Individual
CHARLES E JAFFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
35 TOWER CT, STE F, GURNEE, IL 60031-5712
(847) 360-8440
(847) 360-8468
Mailing address
35 TOWER CT, STE F, GURNEE, IL 60031-5712
(847) 360-8440
(847) 360-8468
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036100907
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100907
—
IL
01
—
2326153
MPIN
IL
01
—
7412520
AETNA
IL
Enumeration date
09/08/2005
Last updated
12/29/2021
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