Provider Demographics
NPI:1669656054
Name:GEIBE, JESSE ROBERT (MD, MPH, MBA)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:ROBERT
Last Name:GEIBE
Suffix:
Gender:M
Credentials:MD, MPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:1122 N. CLARK ST.
Mailing Address - Street 2:#3302
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-7895
Mailing Address - Country:US
Mailing Address - Phone:619-855-5678
Mailing Address - Fax:
Practice Address - Street 1:2410 SAMPSON ST. (FISHER HEALTH CLINIC/NHC-503)
Practice Address - Street 2:NAVAL HEALTH CLINIC GREAT LAKES
Practice Address - City:GREAT LAKES
Practice Address - State:IL
Practice Address - Zip Code:60088-2942
Practice Address - Country:US
Practice Address - Phone:847-688-6712
Practice Address - Fax:847-688-3860
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA13333R2083P0011X, 2083P0500X, 2083P0901X, 2083X0100X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice