Individual
JENNIFER ANNE MCDONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1801 W TAYLOR ST, SUITE 2E, CHICAGO, IL 60612-4795
(312) 996-7416
Mailing address
840 S WOOD ST, MC 856, CHICAGO, IL 60612-4325
(312) 413-0243
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036129241
IL
208000000X
Pediatrics Physician
036129241
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036129241
—
IL
Enumeration date
07/21/2008
Last updated
04/19/2013
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