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NATHAN JETTER MD NPI 1528564994


NPI Information

NPI: 1528564994
Provider Name: NATHAN JETTER, MD
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1801 W TAYLOR ST
SUITE 3E OUTPATIENT CARE CENTER
CHICAGO, IL
ZIP 60612
Phone: (312) 996-8666
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Nathan Jetter, MD is a student in an organized health care education training program in Chicago, IL. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Nathan Jetter, MD NPI is 1528564994. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1801 W TAYLOR ST
SUITE 3E OUTPATIENT CARE CENTER
CHICAGO, IL
ZIP 60612
Phone: (312) 996-8666

The NPI 1528564994 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/3/2018 and was last updated on 5/19/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2390200000XStudent in an Organized Health Care Education/Training Program125072929ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.