Jan Axelbaum, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

036138448 Issued in IL

Practice address

211 S 3Rd St
Belleville, IL 62220-1915

Phone

(618) 234-2120

Fax

(618) 641-5806

NPI assigned

Feb 25, 2009

Last updated

Jun 30, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Jan Mirowitz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jan.axelbaum@3879.securemail.prognocis.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inpatient Consultants of Missouri Inc

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1194779579
  NPD (past)

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1356581730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S 3RD ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201915",
            "telephone_number": "618-234-2120",
            "fax_number": "618-641-5806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S 3RD ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201915",
            "telephone_number": "618-234-2120",
            "fax_number": "618-641-5806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXELBAUM",
        "first_name": "JAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2002001971",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2002001971",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036138448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356581730",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAN",
            "last_name": "MIROWITZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cindy L. Auld, FNP
• Avalcare
• Avc Optometry Inc (Advanced Vision Care)
• Shirley Avellone
• Katie Awad
• Mark Christopher Azar, D.D.S., M.S.
• Glen S Babich, MD
• Ann Marie Bachmann, MSW, LCSW, EDD
• Back Pain Center, Inc.
• Omer M Badahman, MD

• Hospitalist Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Hospitalist Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.