Individual
MR. JEREMY THOMAS BELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10330 S ROBERTS RD, PALOS HILLS, IL 60465-1971
(708) 237-7200
(708) 237-7201
Mailing address
10330 S ROBERTS RD, PALOS HILLS, IL 60465-1971
(708) 237-7200
(708) 237-7200
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085-001406
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085-001406
—
IL
01
—
085001406
BLUE CROSS BLUE SHIELD PROVIDER NUMBER
IL
01
—
P00066169
RAILROAD MEDICARE PROVIDER NUMBER
IL
Enumeration date
05/18/2006
Last updated
12/20/2021
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