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Individual

JEFFREY L OLEJNIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
610 N WESTGATE AVE, JACKSONVILLE, IL 62650
(217) 243-8455
(217) 243-7951
Mailing address
610 N WESTGATE AVE, JACKSONVILLE, IL 62650-1152
(217) 243-8455
(217) 243-7951

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036090909
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036090909
IL
01
06932015
BLUE CROSS BLUE SHIELD
IL
01
086246
HEALTH ALLIANCE
IL
01
14D1018995
CLIA
IL
01
200087204
IRS TAX ID#
IL
01
3333333
UMWA
IL
01
567115
HEALTHLINK
IL
01
DC0359
RAILROAD MEDICARE GROUP N
IL
01
P00144121
RAILROAD MEDICARE PIN #
IL
Enumeration date
04/04/2006
Last updated
05/18/2018
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