Basic Information
| Provider Information | |||||||||
| NPI: | 1588955066 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMIN | ||||||||
| FirstName: | JAIMIN | ||||||||
| MiddleName: | PINAKIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1650 W HARRISON ST | ||||||||
| Address2: | STE 466 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606123800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129425861 | ||||||||
| FaxNumber: | 3125633945 | ||||||||
| Practice Location | |||||||||
| Address1: | 9831 S WESTERN AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606431740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7734453500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2011 | ||||||||
| LastUpdateDate: | 04/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 036137739 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.