Individual
JENNA GENRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3750 W OGDEN AVE, CHICAGO, IL 60623-2426
(872) 588-3000
Mailing address
1532 N KEDZIE AVE APT 3F, CHICAGO, IL 60651-0702
(817) 201-1220
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
209023755
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209023755
STATE LICENSE
IL
01
—
309017555
CS LICENSE
IL
Enumeration date
08/11/2021
Last updated
03/07/2023
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