Provider Demographics
NPI:1790102176
Name:SIMONAIRE, JENNIFER C (DO)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:C
Last Name:SIMONAIRE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:CHRISTINE
Other - Last Name:HEIDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:0S036 CHURCH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1203
Mailing Address - Country:US
Mailing Address - Phone:331-732-6300
Mailing Address - Fax:331-732-6301
Practice Address - Street 1:0S036 CHURCH ST STE 300
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1203
Practice Address - Country:US
Practice Address - Phone:331-732-6300
Practice Address - Fax:331-732-6301
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102205047207K00000X
IL036149621207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology