Provider Demographics
NPI:1295278554
Name:LABEDZ, JASON
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:LABEDZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IL
Mailing Address - Zip Code:60538-1231
Mailing Address - Country:US
Mailing Address - Phone:312-972-3179
Mailing Address - Fax:
Practice Address - Street 1:12337 S ROUTE 59 UNIT 121
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-4626
Practice Address - Country:US
Practice Address - Phone:312-463-9434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-18
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty