Individual ProviderJarren TakakiSurgeryAllopathic & Osteopathic PhysiciansPractice Address1620 W Harrison St, Chicago, IL 60612-3801(312) 942-5000PECOS EnrollmentBased on the most recent information from CMS, provider Jarren Takaki is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1164171880Provider TypeIndividualFull NameTakaki, JarrenGenderMaleSole ProprietorNoEnumeration Date3/21/2022Last Updated6/6/2022Contact InformationPractice LocationPractice Address1620 W Harrison St, Chicago, IL 60612-3801Phone(312) 942-5000FaxUnlisted FaxMailing LocationMailing Address1620 W Harrison St, Chicago, IL 60612-3801PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208600000XPrimaryDescriptionSurgeryAllopathic & Osteopathic PhysiciansLicense125.080285IllinoisCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer