Individual
MR. MARCO ALEJANDRO JARAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
848 N ASHLAND AVE, CHICAGO, IL 60622-5147
(312) 421-1701
(312) 421-1702
Mailing address
848 N ASHLAND AVE, CHICAGO, IL 60622-5147
(312) 421-1701
(312) 421-1702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036094915
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094915
—
IL
Enumeration date
01/24/2007
Last updated
09/19/2014
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