Organization
ASJ MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANUJ JAIN MD (OWNER)
(773) 651-1224
Entity
Organization
Contact information
Practice address
6508 S HALSTED ST, CHICAGO, IL 60621-2616
(773) 651-1224
Mailing address
6508 S HALSTED ST, CHICAGO, IL 60621-2616
(773) 651-1224
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036131733
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036131733
—
IL
Enumeration date
07/06/2018
Last updated
05/30/2025
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