Individual
DR. JENNIFER MELISSA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3761 N STATE ROUTE 1 17, MOMENCE, IL 60954-2400
(815) 472-3923
(815) 472-2816
Mailing address
3761 N STATE ROUTE 1 17, MOMENCE, IL 60954-2400
(815) 472-3923
(815) 472-2816
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036110704
IL
Other
Enumeration date
08/16/2006
Last updated
11/08/2021
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