Individual
JEFFREY A. OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Contact information
Practice address
5215 N CALIFORNIA AVE, CHICAGO, IL 60625-7014
(773) 878-3627
(773) 275-5860
Mailing address
2740 W FOSTER AVE, LL7, CHICAGO, IL 60625
(773) 878-8200
(773) 293-4197
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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