Individual
JENNY BAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7435 W TALCOTT AVE, CHICAGO, IL 60631
(773) 792-7921
Mailing address
7435 W TALCOTT AVE, CHICAGO, IL 60631-3707
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
125064665
IL
207P00000X
Emergency Medicine Physician
2017010604
MO
Other
Enumeration date
06/19/2014
Last updated
06/11/2018
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