Provider Demographics
NPI:1700564028
Name:IGNACIO, JAENELLE (DNP)
Entity Type:Individual
Prefix:DR
First Name:JAENELLE
Middle Name:
Last Name:IGNACIO
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 N HALSTED ST APT 406
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-2346
Mailing Address - Country:US
Mailing Address - Phone:414-324-3130
Mailing Address - Fax:
Practice Address - Street 1:9680 GOLF RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1522
Practice Address - Country:US
Practice Address - Phone:773-917-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI245319-30163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine