Individual
DR. SYED HASSAN KHALID JAFRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3333 W DEYOUNG ST, MARION, IL 62959-5884
(618) 998-7492
Mailing address
PO BOX 1105, INDIANAPOLIS, IN 46206-1105
(618) 457-5200
(618) 351-4821
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036114889
IL
207Q00000X
Family Medicine Physician
036114889
IL
207R00000X
Internal Medicine Physician
036-114889
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036076429
BCBS
IL
05
—
K28747
—
IL
01
—
P00356268
RAIL ROAD MEDICARE
IL
Enumeration date
07/14/2006
Last updated
01/29/2024
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