Individual
IAN GREG JASENOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1220 S WOOD ST, CHICAGO, IL 60608-1202
(312) 413-1453
Mailing address
1220 S WOOD ST, CHICAGO, IL 60608-1202
(312) 413-3282
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036083005
IL
Other
Enumeration date
06/21/2006
Last updated
10/30/2023
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