Individual
DEEPANJALI JAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2151 WAUKEGAN RD STE 110, BANNOCKBURN, IL 60015-1857
(847) 236-1300
Mailing address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036161107
IL
207R00000X
Internal Medicine Physician
MT217511
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MT217511
—
PA
Enumeration date
06/24/2019
Last updated
07/31/2025
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