Individual
JENNIFER M CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
704 S WEBSTER AVE, GREEN BAY, WI 54301-3528
(920) 433-6050
(920) 433-6049
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550
(630) 789-2571
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
036-094893
IL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
3258-320
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633083
BCBS IL
IL
05
—
036094893
—
IL
01
—
383649745
OWCP PROVIDER ID
IL
Enumeration date
09/23/2005
Last updated
10/05/2023
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