Individual
JEANETTE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
152 N ADDISON AVE, STE 200, ELMHURST, IL 60126-2810
(630) 832-3100
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036097683
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036097683
—
IL
Enumeration date
02/20/2006
Last updated
08/07/2023
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