Individual
JAI JUNG NHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15 COMMERCE DR STE 113, GRAYSLAKE, IL 60030-7807
(847) 231-5300
(847) 231-5303
Mailing address
15 COMMERCE DR STE 113, GRAYSLAKE, IL 60030-7807
(847) 231-5300
(847) 231-5303
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036052229
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036052229
PHYSICIAN LICENSE
IL
05
—
036052229
—
IL
01
—
0491507812
BLUE CROSS BLUE SHIELD
—
Enumeration date
09/22/2005
Last updated
08/01/2022
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