Organization
FATIMA JAFFER MD SC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FATIMA E JAFFER M.D. (PRESIDENT)
(630) 789-3133
Entity
Organization
Contact information
Practice address
PHYSICIANS PAVILION SUITE 101, 24 EAST JOLIET STREET, DYER, IN 46311
(219) 865-2141
(219) 864-2644
Mailing address
PO BOX 5758, VILLA PARK, IL 60181-5308
(630) 789-3133
(630) 789-3379
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01044403A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000353010
BLUE CROSS BLUE SHIELD
IN
Enumeration date
05/04/2007
Last updated
08/22/2020
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