Individual
DR. JALAJA V. PISKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10095 W LINCOLN HWY, FRANKFORT, IL 60423
(815) 806-0400
(815) 806-0406
Mailing address
10095 W LINCOLN HWY, FRANKFORT, IL 60423-1272
(815) 806-0400
(815) 806-0406
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036104071
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
036-104071
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2044193076012201
—
IL
01
—
213680
MEDICARE
IL
Enumeration date
12/27/2005
Last updated
11/10/2023
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