Provider Demographics
NPI:1922070333
Name:JATOI, NAEEMUDDIN (MD)
Entity Type:Individual
Prefix:DR
First Name:NAEEMUDDIN
Middle Name:
Last Name:JATOI
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 1:176 W MOUND RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-1964
Mailing Address - Country:US
Mailing Address - Phone:217-875-0163
Mailing Address - Fax:217-875-9007
Practice Address - Street 1:176 W MOUND RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-1964
Practice Address - Country:US
Practice Address - Phone:217-875-0163
Practice Address - Fax:217-875-9007
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-100857208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5815191OtherBC/BS
IL896414OtherHEALTHLINK
ILK50036Medicare PIN