Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 036108815 | IL |
NPI | 1023021433 |
---|---|
Provider Name | Dr. Jennifer L Maschmann |
First Address | Spring Valley, IL 61362-1512 |
Second Address | Spring Valley, IL 61362-1512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 25/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036108815 | (05) | IL |
H85253 | (02) |