Individual
JAMES EDWARD JUPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
900 N WESTMORELAND RD, SUITE 108, LAKE FOREST, IL 60045-1674
(847) 615-5419
(847) 615-5423
Mailing address
PO BOX 431, LAKE FOREST, IL 60045-0431
(847) 775-7686
(847) 735-9301
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207RI0200X
Infectious Disease Physician
036041939
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036041939
—
IL
01
—
04927816
BC/BS ILLINOIS
IL
Enumeration date
08/14/2006
Last updated
03/15/2011
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