Individual
JENNIFER EIDAM BABIARZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
900 W NELSON ST, CHICAGO, IL 60657-6704
(773) 296-7089
Mailing address
900 W NELSON ST, CHICAGO, IL 60657-6704
(773) 296-7089
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085.003193
IL
363AM0700X
Medical Physician Assistant
1000539
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
191433
MEDCOST
—
01
—
7980836
AETNA
—
Enumeration date
09/14/2006
Last updated
12/27/2021
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