Provider Demographics
NPI:1801851753
Name:KAUFMAN, JONATHAN M (MD)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:M
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 NORTHWEST HIGHWAY
Mailing Address - Street 2:SUITE G-7
Mailing Address - City:FOX RIVER GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60021
Mailing Address - Country:US
Mailing Address - Phone:847-381-6700
Mailing Address - Fax:847-381-6828
Practice Address - Street 1:27790 W HWY 22
Practice Address - Street 2:STE 22
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010
Practice Address - Country:US
Practice Address - Phone:847-381-6700
Practice Address - Fax:847-381-6828
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036074412208000000X
IL036-074412208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics