Individual
M R JAYASANKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
.M.D
Contact information
Practice address
505 N LAKE SHORE DR, 1112, CHICAGO, IL 60611-3427
(312) 804-2146
(312) 804-2146
Mailing address
505 N LAKE SHORE DR, 1112, CHICAGO, IL 60611-3427
(312) 804-2146
(312) 804-2146
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036 045002
IL
Other
Enumeration date
02/27/2013
Last updated
02/27/2013
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