Provider Demographics
NPI:1760412407
Name:PERRIN, M. JANE H (MD)
Entity Type:Individual
Prefix:
First Name:M. JANE
Middle Name:H
Last Name:PERRIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2546
Mailing Address - Country:US
Mailing Address - Phone:847-256-1860
Mailing Address - Fax:
Practice Address - Street 1:JOHN H. STROGER, JR. HOSPITAL OF COOK COUNTY
Practice Address - Street 2:1901 W HARRISON ST.
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3714
Practice Address - Country:US
Practice Address - Phone:312-864-4400
Practice Address - Fax:312-864-9500
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-078135207RG0300X
IL036-118000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG-18237Medicare UPIN