Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | 235208 | NY |
Y | 2080P0208X | Pediatric Infectious Diseases | 036104230 | IL |
NPI | 1295779908 |
---|---|
Provider Name | Jennifer Jao |
First Address | Chicago, IL 60611 |
Second Address | Chicago, IL 60611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 28/02/2020 |