Individual
JENNIFER ANN ALDERINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
900 I ST, LA PORTE, IN 46350-5533
(219) 324-1700
(219) 324-1602
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003760A
IN
207Q00000X
Family Medicine Physician
5101019506
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201008190
—
IN
Enumeration date
07/06/2009
Last updated
03/30/2021
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