Provider Demographics
NPI:1699161448
Name:STINE, JAYME LYNN (MD)
Entity type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:LYNN
Last Name:STINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JAYME
Other - Middle Name:LYNN
Other - Last Name:HUFSTEDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3333 BURNET AVENUE
Mailing Address - Street 2:ML 5018
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:740-636-4315
Mailing Address - Fax:513-636-7905
Practice Address - Street 1:3517 W ARTHINGTON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-4165
Practice Address - Country:US
Practice Address - Phone:872-588-3510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036.147063208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program