Provider Demographics
NPI:1295737088
Name:DEJESUS, ERNEST F (MD)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:F
Last Name:DEJESUS
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 W 22ND ST
Mailing Address - Street 2:STE 200
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1563
Mailing Address - Country:US
Mailing Address - Phone:630-573-5000
Mailing Address - Fax:
Practice Address - Street 1:25 WINFIELD ROAD
Practice Address - Street 2:SUITE 414
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190
Practice Address - Country:US
Practice Address - Phone:630-690-1220
Practice Address - Fax:630-690-5323
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.109525207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK18199Medicare PIN
ILI31254Medicare UPIN