Provider Demographics
NPI:1588845937
Name:JASMINE SINGH M.D, S.C.
Entity Type:Organization
Organization Name:JASMINE SINGH M.D, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-684-9464
Mailing Address - Street 1:3908 N CASS AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1103
Mailing Address - Country:US
Mailing Address - Phone:630-241-4515
Mailing Address - Fax:630-241-4530
Practice Address - Street 1:2117 E 71ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2103
Practice Address - Country:US
Practice Address - Phone:773-684-9464
Practice Address - Fax:773-684-9492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036097058207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1622782OtherBCBS
IL036097058Medicaid
IL208113Medicare PIN
IL1622782OtherBCBS
IL211821Medicare PIN