Provider Demographics
NPI:1346228814
Name:MARKS, JULES A (DO)
Entity Type:Individual
Prefix:DR
First Name:JULES
Middle Name:A
Last Name:MARKS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25233 NETWORK PLACE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1252
Mailing Address - Country:US
Mailing Address - Phone:630-390-1240
Mailing Address - Fax:630-390-1247
Practice Address - Street 1:1450 BUSCH PARKWAY
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-4541
Practice Address - Country:US
Practice Address - Phone:847-537-7744
Practice Address - Fax:847-537-9719
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03684408207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36084408Medicaid
IL36084408Medicaid
E47044Medicare UPIN