Clemis, Jack D

Clemis, Jack D is an individual health care provider with primary practice located at 151 N Michigan Ave #914, Chicago IL 60601-7506. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otology & Neurotology, which is considered as his primary health care specialty. Clemis, Jack D can be contacted via phone (312) 938-4327.

Contact Information

Primary practice address
151 N Michigan Ave #914 Chicago IL 60601-7506
Phone: (312) 938-4327
Fax: (312) 938-0490
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otology & Neurotology 207YX0901X 036-038421 Illinois

Profile Details

NPI number 1740272483
LBN Legal business name Clemis, Jack D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Feb 13th, 2013 - about 11 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 1740272483 NPPES
Illinois Other 1604366 BLUE CROSS

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