Provider Demographics
NPI:1215402425
Name:JENIG, LINDA
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:JENIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 THOMAS DRIVE
Mailing Address - Street 2:
Mailing Address - City:10000 DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191
Mailing Address - Country:US
Mailing Address - Phone:630-808-6770
Mailing Address - Fax:
Practice Address - Street 1:230 THOMAS DRIVE
Practice Address - Street 2:
Practice Address - City:10000 DALE
Practice Address - State:IL
Practice Address - Zip Code:60191
Practice Address - Country:US
Practice Address - Phone:630-808-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No344600000XTransportation ServicesTaxi
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker