# JENNIFER M CUNNINGHAM

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

## Provider details

- **NPI number:** 1790771962
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 036-094893 | IL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 3258-320 | WI | Yes |

## Other

- **Enumeration date:** 09/23/2005
- **Last updated:** 10/05/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01633083 | BCBS IL | IL |
| 05 | — | 036094893 | — | IL |
| 01 | — | 383649745 | OWCP PROVIDER ID | IL |