Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 016004910 | IL |
N | 213ES0131X | Foot Surgery | 016004910 | IL |
NPI | 1225092901 |
---|---|
Provider Name | Jennifer Lynn Kaleta |
First Address | Mount Prospect, IL 60056-6023 |
Second Address | Naperville, IL 60564-8044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 20/12/2021 |