Individual
DR. JONATHAN YOUNG JI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
615 N MICHIGAN ST FL 1, SOUTH BEND, IN 46601-1033
(574) 647-1610
Mailing address
53842 GENERATIONS DR, SOUTH BEND, IN 46635-1543
(574) 647-1069
(574) 647-6949
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01064532A
IN
2084N0400X
Neurology Physician
036162049
IL
2084N0400X
Neurology Physician
21273
WI
2084N0400X
Neurology Physician
77177
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100181475
—
WI
05
—
201315870
—
IN
Enumeration date
01/11/2007
Last updated
12/17/2024
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