Provider Demographics
NPI:1558503425
Name:LEOPOLD, JAYE M (RN, MSN, CDE)
Entity Type:Individual
Prefix:MS
First Name:JAYE
Middle Name:M
Last Name:LEOPOLD
Suffix:
Gender:F
Credentials:RN, MSN, CDE
Other - Prefix:
Other - First Name:JAYE
Other - Middle Name:
Other - Last Name:SENGEWALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-8200
Mailing Address - Country:US
Mailing Address - Phone:815-725-7133
Mailing Address - Fax:815-773-7745
Practice Address - Street 1:333 MADISON ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8200
Practice Address - Country:US
Practice Address - Phone:815-725-7133
Practice Address - Fax:815-773-7745
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041177774163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator