Provider Demographics
NPI:1760476550
Name:HASLER, JENNY K (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:K
Last Name:HASLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNY
Other - Middle Name:N
Other - Last Name:KOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2300 N CHILDRENS PLZ
Mailing Address - Street 2:BOX 152
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3363
Mailing Address - Country:US
Mailing Address - Phone:773-880-6903
Mailing Address - Fax:773-880-3068
Practice Address - Street 1:2300 N CHILDRENS PLZ
Practice Address - Street 2:OUTREACH PHYSICIAN SERVICES
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3363
Practice Address - Country:US
Practice Address - Phone:773-880-6903
Practice Address - Fax:773-880-3068
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-097035208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036097035Medicaid