Provider Demographics
NPI:1477818714
Name:ANDREOLI, JESSICA MARGARET (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MARGARET
Last Name:ANDREOLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:MARGARET
Other - Last Name:DAVISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:25 N WINFIELD RD STE 103
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1379
Mailing Address - Country:US
Mailing Address - Phone:630-933-4487
Mailing Address - Fax:630-933-2009
Practice Address - Street 1:25 N WINFIELD RD STE 103
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1379
Practice Address - Country:US
Practice Address - Phone:630-933-4487
Practice Address - Fax:630-933-2009
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361384992085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology