Individual
JENNA MICHELE MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5841 S MARYLAND AVE # MC3051, CHICAGO, IL 60637-1443
(773) 219-2011
Mailing address
1472 W SUMMERDALE AVE APT 2RE, CHICAGO, IL 60640-2159
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209020806
IL
Other
Enumeration date
08/16/2020
Last updated
08/16/2020
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