Provider Demographics
NPI:1902010630
Name:JASINSKA, HANNA JOZEFA (MD)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:JOZEFA
Last Name:JASINSKA
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 1:5632 W LAWRENCE AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-3220
Mailing Address - Country:US
Mailing Address - Phone:773-286-5585
Mailing Address - Fax:773-286-9602
Practice Address - Street 1:5632 W LAWRENCE AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-3220
Practice Address - Country:US
Practice Address - Phone:773-286-5585
Practice Address - Fax:773-286-9602
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
211417Medicare ID - Type Unspecified
ILC49499Medicare UPIN