Jasek, Andrzej M

Jasek, Andrzej M is an individual health care provider with primary practice located at 5875 E Riverside Blvd , Rockford IL 61114-4937. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Jasek, Andrzej M can be contacted via phone (815) 398-9491.

Contact Information

Primary practice address
5875 E Riverside Blvd Rockford IL 61114-4937
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 41875 Wisconsin
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 036-092808 Illinois

Profile Details

NPI number 1578636692
LBN Legal business name Jasek, Andrzej M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2006
Last updated Oct 31st, 2023 - about 2 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 1578636692 NPPES
Wisconsin MEDICAID 32287100
Wisconsin MEDICAID 036092808 1

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