Basic Information
Provider Information
NPI: 1316239734
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: UEJIMA
FirstName: JAMIE
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 680 N LAKE SHORE DR
Address2: 1000
City: CHICAGO
State: IL
PostalCode: 606114546
CountryCode: US
TelephoneNumber: 3126950061
FaxNumber: 3126959013
Practice Location
Address1: 251 E HURON FEINBERG 5-704
Address2:  
City: CHICAGO
State: IL
PostalCode: 60611
CountryCode: US
TelephoneNumber: 3126950061
FaxNumber: 3126959013
Other Information
ProviderEnumerationDate: 05/03/2011
LastUpdateDate: 09/12/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X036137523ILY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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