Provider Demographics
NPI:1568672152
Name:NEAGLE, JAYSON T (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYSON
Middle Name:T
Last Name:NEAGLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:251 E HURON ST
Mailing Address - Street 2:FEINBERG 16-738
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2908
Mailing Address - Country:US
Mailing Address - Phone:312-926-5924
Mailing Address - Fax:312-926-6134
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:FEINBERG 16-738
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-5924
Practice Address - Fax:312-926-6134
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2016-05-19
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Provider Licenses
StateLicense IDTaxonomies
IL036.120932208M00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist