Individual
DR. JONDELLE B. JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1706 E 87TH ST, CHICAGO, IL 60617-2740
(773) 374-5300
(773) 374-5860
Mailing address
1706 E 87TH ST, CHICAGO, IL 60617-2740
(773) 374-5300
(773) 374-5860
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016003520
IL
213EP1101X
Primary Podiatric Medicine Podiatrist
016003520
IL
213ER0200X
Radiology Podiatrist
016003520
IL
213ES0000X
Sports Medicine Podiatrist
016003520
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
016003520
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001621735
BLUE CROSS BLUE SHIELD
IL
05
—
016003520
—
IL
01
—
P00276675
RAILROAD MEDICARE
IL
Enumeration date
10/16/2006
Last updated
10/03/2022
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