Individual
JENNA PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3 ERIE CT STE 1300, OAK PARK, IL 60302-2519
(708) 406-3929
(708) 406-3935
Mailing address
641 W GRAND AVE APT 4, CHICAGO, IL 60654-5534
(612) 205-7959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.014598
IL
Other
Enumeration date
08/07/2016
Last updated
01/02/2020
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