Provider Demographics
NPI:1770738007
Name:D V JAHN INC
Entity type:Organization
Organization Name:D V JAHN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DMITRIY
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:JAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-452-2975
Mailing Address - Street 1:25661 NORTH HILLVIEW CT
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-9426
Mailing Address - Country:US
Mailing Address - Phone:847-550-1898
Mailing Address - Fax:
Practice Address - Street 1:25661 NORTH HILLVIEW CT
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-9426
Practice Address - Country:US
Practice Address - Phone:847-550-1898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203001045332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203001045OtherLICENSE
IL6351190001Medicare NSC