Provider Demographics
NPI:1174635718
Name:ORGAIN, JAVETTE C (MD MPH)
Entity Type:Individual
Prefix:
First Name:JAVETTE
Middle Name:C
Last Name:ORGAIN
Suffix:
Gender:F
Credentials:MD MPH
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 806527
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60680-4126
Mailing Address - Country:US
Mailing Address - Phone:312-833-1077
Mailing Address - Fax:877-825-1491
Practice Address - Street 1:2555 S KING DR
Practice Address - Street 2:FLAWLESS INC. 2ND FLOOR C/O R. PHILLIPS, COO
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2419
Practice Address - Country:US
Practice Address - Phone:312-833-1077
Practice Address - Fax:877-825-1491
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036066754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E60946Medicare UPIN