Provider Demographics
NPI:1164793949
Name:CANDEL, JENNIFER JAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JAYNE
Last Name:CANDEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19W031 AVENUE CHATEAUX N
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1660
Mailing Address - Country:US
Mailing Address - Phone:630-434-2256
Mailing Address - Fax:630-434-2256
Practice Address - Street 1:19W031 AVENUE CHATEAUX N
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1660
Practice Address - Country:US
Practice Address - Phone:630-434-2256
Practice Address - Fax:630-434-2256
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.087903207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics