Provider Demographics
NPI:1841390572
Name:JENKINS, CARY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:ANN
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 LAKEWOOD DR
Mailing Address - Street 2:UNIT A
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-1709
Mailing Address - Country:US
Mailing Address - Phone:847-738-0542
Mailing Address - Fax:
Practice Address - Street 1:1499 LAKEWOOD DR
Practice Address - Street 2:UNIT A
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-1709
Practice Address - Country:US
Practice Address - Phone:815-941-5160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36165207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology