Provider Demographics
NPI:1912993429
Name:IGNACIO, JEMINI G (MD)
Entity type:Individual
Prefix:DR
First Name:JEMINI
Middle Name:G
Last Name:IGNACIO
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1860 PAYSHERE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-0001
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:1141 E MAIN ST
Practice Address - Street 2:SUITE 105
Practice Address - City:EAST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-2440
Practice Address - Country:US
Practice Address - Phone:847-428-3322
Practice Address - Fax:847-428-0472
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2021-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-103412207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH47150Medicare UPIN