Provider Demographics
NPI:1003399700
Name:JENNIFER E HASSLER LLC
Entity Type:Organization
Organization Name:JENNIFER E HASSLER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:LUANN
Authorized Official - Last Name:FRIGULETTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-974-6880
Mailing Address - Street 1:1000 JORIE BLVD STE 48
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4498
Mailing Address - Country:US
Mailing Address - Phone:630-974-6880
Mailing Address - Fax:630-974-6115
Practice Address - Street 1:1000 JORIE BLVD STE 48
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4498
Practice Address - Country:US
Practice Address - Phone:630-974-6880
Practice Address - Fax:630-974-6115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1487742557Medicaid