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
Phone: (815) 929-1388
Fax: (815) 935-7062
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669412433 | NPPES |
| Illinois | MEDICAID | 036101753 | |
| Illinois | Other | P01059367 |
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