Provider Demographics
NPI:1396567004
Name:NOVY, JENNIFER ANNE (CPG)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNE
Last Name:NOVY
Suffix:
Gender:F
Credentials:CPG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 TOUHY AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3254
Mailing Address - Country:US
Mailing Address - Phone:847-324-9450
Mailing Address - Fax:847-999-3663
Practice Address - Street 1:5550 TOUHY AVE STE 300
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3254
Practice Address - Country:US
Practice Address - Phone:847-324-9450
Practice Address - Fax:847-999-3663
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3001475253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care