Dustin, Jack
Dustin, Jack is an sole proprietor health care provider with primary practice located at 540 Lake Cook Rd , Deerfield IL 60015-5289. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Dustin, Jack can be contacted via phone (847) 564-8500.Contact Information
Primary practice address
540 Lake Cook Rd
Deerfield IL 60015-5289
Phone: (847) 564-8500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 336.023475 | Illinois |
Profile Details
| NPI number | 1184996472 |
|---|---|
| LBN Legal business name | Dustin, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 1st, 2012 |
| Last updated | Feb 1st, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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