Olsen, Jon

Olsen, Jon is an individual health care provider with primary practice located at 1775 Dempster , Park Ridge IL 60068. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Olsen, Jon can be contacted via phone (847) 723-7624.

Contact Information

Primary practice address
1775 Dempster Park Ridge IL 60068
Phone: (847) 723-7624
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036075520 Illinois

Profile Details

NPI number 1083783930
LBN Legal business name Olsen, Jon
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2006
Last updated Feb 20th, 2023 - about last year

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 1083783930 NPPES
Illinois MEDICAID 036075520

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