Provider Demographics
NPI:1306869284
Name:MONO, JEFFREY A (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:MONO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8901 W GOLF RD
Mailing Address - Street 2:#300
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016
Mailing Address - Country:US
Mailing Address - Phone:847-824-3127
Mailing Address - Fax:847-824-3347
Practice Address - Street 1:8901 W GOLF RD
Practice Address - Street 2:#300
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016
Practice Address - Country:US
Practice Address - Phone:847-824-3127
Practice Address - Fax:847-824-3347
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036070735207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5639OtherADVOCATE HEALTH
IL036070735Medicaid
IL0338490081OtherADMINISTAR FEDERAL
IL5639OtherADVOCATE HEALTH
ILP04062Medicare ID - Type Unspecified
IL036070735Medicaid