Individual
JAIME REBECCA OBSZANSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
21481 N RAND RD, KILDEER, IL 60047-3061
(847) 618-9655
(847) 618-9654
Mailing address
21481 N RAND RD, KILDEER, IL 60047-3061
(847) 618-9655
(847) 618-9654
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036149324
IL
207Q00000X
Family Medicine Physician
125.061102
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036149324
STATE LICENSE
IL
Enumeration date
05/30/2012
Last updated
08/19/2022
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