Jonathan Spero, MD
Individual provider Active NPI Emergency Medicine Physician · Middlebury, IN
NPI 1184693111 · NPPES record last updated May 9, 2019
Key facts
- NPI
- 1184693111
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 036-108385 (IL)
- Practice address
- 407 N Main St
Middlebury, IN 46540-9218 - Phone
- (630) 730-0364
- Fax
- (630) 206-1255
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-108385 | IL | MD | Emergency Medicine Physician |
| 036108385 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roosevelt Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
| Inhouse Physicians, S.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036108385 | IL | |
| Emergency Medicine Physician | 207P00000X | 036-108385 | IL | Yes |
Addresses
Primary practice location
407 N Main St
Middlebury, IN 46540-9218
Mailing address
1560 Wall St Ste 335
Naperville, IL 60563-1267
Phone (630) 730-0364
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F19073 | Medicaid | IL |
Other providers in Middlebury, IN
- Shobhit Sharma
- Emily Elizabeth Shaver
- Kimberly L Skupski
- Greta Slabach
- Julie Renee Snyder
- Paxton Starrett
- Pamela Jo Stearns
- Carla Sue Strater
- Marcy Lynn Thomas
- Bailey Nicole Tresenriter
All providers in Middlebury, IN · Emergency Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.