Organization
DINESH K. JAIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DINESH K JAIN M.D. (SOLE PROPRIETOR)
(708) 429-2220
Entity
Organization
Contact information
Practice address
16532 OAK PARK AVE, SUITE 101, TINLEY PARK, IL 60477-1918
(708) 429-2220
(708) 342-1521
Mailing address
PO BOX 159, MATTESON, IL 60443-0159
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036-067930
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01628096
GROUP BLUE SHIELD
IL
Enumeration date
05/24/2006
Last updated
11/25/2009
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