Provider Demographics
NPI:1164735403
Name:JASINSKI, GREGORY (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:JASINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2S631 STATE ROUTE 59 STE E
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-1464
Mailing Address - Country:US
Mailing Address - Phone:630-216-9098
Mailing Address - Fax:630-447-0008
Practice Address - Street 1:2S631 STATE ROUTE 59 STE E
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-1464
Practice Address - Country:US
Practice Address - Phone:630-216-9098
Practice Address - Fax:630-447-0008
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1398232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry