# JEANINE CONNOLLY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1346203064
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RR0500X | Rheumatology Physician | 036104880 | IL | Yes |

## Other

- **Enumeration date:** 04/11/2006
- **Last updated:** 01/24/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036104880 | — | IL |
| 01 | — | P00156797 | RAILROAD MEDICARE | IL |