Maly, Jasmine Mathew

Maly, Jasmine Mathew is an individual health care provider with primary practice located at 400 N Wall St Suite 304, Kankakee IL 60901-2940. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Maly, Jasmine Mathew can be contacted via phone (815) 929-1388.

Contact Information

Primary practice address
400 N Wall St Suite 304 Kankakee IL 60901-2940
Fax: (815) 935-7062
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 036101753 Illinois
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 01074614A Indiana

Profile Details

NPI number 1669412433
LBN Legal business name Maly, Jasmine Mathew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Mar 12th, 2018 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1669412433 NPPES
Illinois MEDICAID 036101753
Illinois Other P01059367

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