Provider Demographics
NPI:1992199947
Name:JANDURA, DAVID MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARK
Last Name:JANDURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:880 W CENTRAL RD STE 4500
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2388
Mailing Address - Country:US
Mailing Address - Phone:847-398-2777
Mailing Address - Fax:847-394-2777
Practice Address - Street 1:880 W CENTRAL RD STE 4500
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2388
Practice Address - Country:US
Practice Address - Phone:847-398-2777
Practice Address - Fax:847-394-2777
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036146380207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036146380OtherSTATE LICENSE