Provider Demographics
NPI:1336416767
Name:JOSHI, JIGAR VIRENBHAI (MBBS, MD, HMDC)
Entity Type:Individual
Prefix:
First Name:JIGAR
Middle Name:VIRENBHAI
Last Name:JOSHI
Suffix:
Gender:M
Credentials:MBBS, MD, HMDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 S DAMEN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1170
Mailing Address - Country:US
Mailing Address - Phone:312-945-9750
Mailing Address - Fax:
Practice Address - Street 1:1340 S DAMEN AVE STE 200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1170
Practice Address - Country:US
Practice Address - Phone:312-997-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036136777207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine