Axelbaum, Jan

Axelbaum, Jan is an individual health care provider with primary practice located at 211 S 3Rd St , Belleville IL 62220-1915. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Axelbaum, Jan can be contacted via phone (618) 234-2120.

Contact Information

Primary practice address
211 S 3Rd St Belleville IL 62220-1915
Phone: (618) 234-2120
Fax: (618) 641-5806
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 2002001971 Missouri
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 2002001971 Missouri
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 036138448 Illinois

Profile Details

NPI number 1356581730
LBN Legal business name Axelbaum, Jan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 25th, 2009
Last updated Jun 30th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356581730 NPPES
Missouri MEDICAID 1356581730

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