Dejean Wellness

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DEJEAN WELLNESS

Practice address

326 W 64TH St
Suite 5
Chicago, IL 60621-3114

Phone

(773) 962-4672

NPI assigned

Aug 24, 2009

Last updated

Aug 24, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Andre T Dejean, MD

Title

Physician

Phone

(773) 962-4672

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Andre T Dejean Dejean Wellness2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Andre T Dejean /Dejean Wellness

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1952532426
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251072000000",
    "number": "1255564316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 W 64TH ST",
            "address_2": "SUITE 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213114",
            "telephone_number": "773-962-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 W 64TH ST",
            "address_2": "SUITE 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213114",
            "telephone_number": "773-962-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEJEAN WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-24",
        "last_updated": "2009-08-24",
        "status": "A",
        "authorized_official_last_name": "DEJEAN",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "773-962-4672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098445",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nimrod Deiss-Yehiely, MD
• Felix Kate Deiss, PSY.D.
• Deitch Pharmacy Inc.
• Drake Deitch
• Lisa Marie Dejanovich, PTA
• William Paul Dejean, DDS
• Abel Dejene, LPC
• Carroll Dejesus
• Luremny Dejesus, MSCCCSLP
• Yaritza Dejesus, LCPC

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.