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Individual

JENNIFER E CHEESBOROUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
125056694
IL
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
142370
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125056694
STATE LICENSE NUMBER
IL
Enumeration date
07/02/2009
Last updated
06/28/2016
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