Individual
JENALEN F PARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 ADAMS ST, GILLESPIE, IL 62033-1421
(217) 313-5621
Mailing address
207 ADAMS ST, GILLESPIE, IL 62033-1421
(217) 313-5621
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P620-4267-7881
N/A
IL
Enumeration date
02/23/2023
Last updated
02/23/2023
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