Individual
JEFFREY A. OLSON
Active
Individual
JEFFREY A. OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0000
IL
207R00000X
Internal Medicine Physician
A75543
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.110640
STATE LICENSE
IL
01
—
336.071295
CDS LIC
IL
Enumeration date
02/10/2006
Last updated
03/07/2023
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