Individual
KATHERINE JELINEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
302 RANDALL RD, GENEVA, IL 60134-4209
(630) 262-7400
(630) 262-3760
Mailing address
302 RANDALL RD, GENEVA, IL 60134-4209
(630) 262-7400
(630) 262-3760
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036-108039
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108039
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
CA4748
MEDICARE RR (GROUP)
IL
01
—
F400122269
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
P01308433
MEDICARE RR (INDIVIDUAL)
IL
Enumeration date
11/01/2006
Last updated
06/26/2014
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