Individual
JERMAINE KYONG WHITE
Active
Individual
JERMAINE KYONG WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036.139117
IL
207P00000X
Emergency Medicine Physician
125-059996
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036139117
—
IL
01
—
F400464740
MEDICARE PTAN
IL
Enumeration date
07/07/2011
Last updated
09/05/2018
Update your record
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