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Individual

JAY JOSHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
21720 W LONG GROVE RD, STE. C200, DEER PARK, IL 60010-3732
(847) 701-3250
(847) 701-3300
Mailing address
21720 W LONG GROVE RD, STE. C200, DEER PARK, IL 60010-3732
(847) 701-3250
(847) 701-3300

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
036115191
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
131846500
DEPARTMENT OF LABOR
IL
01
1619628
BCBS PROVIDER
IL
01
363756275
TAX ID
IL
Enumeration date
05/17/2006
Last updated
01/05/2015
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