Chamberlin, Jack R
Chamberlin, Jack R is an individual health care provider with primary practice located at 800 Biesterfield Rd Ste G01 Wimmer Building, Elk Grove Village IL 60007-3372. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Chamberlin, Jack R can be contacted via phone (847) 981-3680.Contact Information
Primary practice address
800 Biesterfield Rd Ste G01 Wimmer Building
Elk Grove Village IL 60007-3372
Phone: (847) 981-3680
Fax: (847) 956-5122
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036086925 | Illinois |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 036-086925 | Illinois |
Profile Details
| NPI number | 1215980321 |
|---|---|
| LBN Legal business name | Chamberlin, Jack R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2006 |
| Last updated | Apr 10th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215980321 | NPPES |
| Illinois | Other | IL6305015 | MEDICARE PTAN LOC 15 |
| Illinois | Other | 1720371669 | MEDICARE PTAN LOC 15 |
| Illinois | Other | IL6304015 | MEDICARE PTAN LOC 15 |
| Illinois | Other | P01008734 | MEDICARE PTAN LOC 15 |
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