Provider Demographics
NPI:1891744611
Name:ROJAS, JAIME A (MS, ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:JAIME
Middle Name:A
Last Name:ROJAS
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 W 15TH ST APT 216
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3415
Mailing Address - Country:US
Mailing Address - Phone:312-342-0697
Mailing Address - Fax:
Practice Address - Street 1:5616 W 63RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-5511
Practice Address - Country:US
Practice Address - Phone:773-526-5239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist