Individual
JENNIFER CRYSTAL BIESIADECKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
540 HOSPITAL DR, WINAMAC, IN 46996-1173
(574) 946-2194
Mailing address
1037 DES PLAINES AVE APT 507, FOREST PARK, IL 60130-2152
(815) 508-9320
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02006838A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2019
Last updated
07/18/2022
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