Provider Demographics
NPI:1285724765
Name:JAFFE, HOWARD ARYA (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:ARYA
Last Name:JAFFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:H.
Other - Middle Name:ARI
Other - Last Name:JAFFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:820 SOUTH DAMEN STREET
Mailing Address - Street 2:PCCSM, DEPT MED (111), JESSE BROWN VA MEDICAL CENTER
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-569-6906
Mailing Address - Fax:312-569-8123
Practice Address - Street 1:820 SOUTH DAMEN STREET
Practice Address - Street 2:PCCSM, DEPT MED (111), JESSE BROWN VA MEDICAL CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-569-6906
Practice Address - Fax:312-569-8123
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF87272Medicare UPIN