Provider Demographics
NPI:1295261253
Name:JARAVA, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:JARAVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 W DIVISION ST STE 235
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2989
Mailing Address - Country:US
Mailing Address - Phone:773-342-6800
Mailing Address - Fax:773-342-6332
Practice Address - Street 1:2222 W DIVISION ST STE 235
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2989
Practice Address - Country:US
Practice Address - Phone:773-342-6800
Practice Address - Fax:773-342-6332
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036152721207RG0100X
NM390200000X
NMMD2023-1280207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program