Provider Demographics
NPI:1740454305
Name:MOKFI, JACQUELINE J (MD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:J
Last Name:MOKFI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:J
Other - Last Name:JANKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5215 HOLY CROSS PARKWAY
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545
Mailing Address - Country:US
Mailing Address - Phone:574-335-5000
Mailing Address - Fax:
Practice Address - Street 1:5215 HOLY CROSS PARKWAY
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IL
Practice Address - Zip Code:46545
Practice Address - Country:US
Practice Address - Phone:574-335-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041838207R00000X, 207RC0200X, 207RI0200X
IN01072102A207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease