Organization
INFORME HEALTHCARE TN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI M CZERNEJEWSKI (OWNER)
(414) 242-5468
Entity
Organization
Contact information
Practice address
709 WALNUT ST, CHATTANOOGA, TN 37402-1916
(423) 266-7721
Mailing address
2741 W LAYTON AVE STE 106, MILWAUKEE, WI 53221-2600
(414) 242-5468
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q045823
—
TN
Enumeration date
12/03/2018
Last updated
04/30/2020
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