Provider Demographics
NPI:1801897566
Name:FELSKE, JENNIFER M (DPM)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:M
Last Name:FELSKE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 GUNDERSEN DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2402
Mailing Address - Country:US
Mailing Address - Phone:630-665-9155
Mailing Address - Fax:630-665-5557
Practice Address - Street 1:327 GUNDERSEN DR
Practice Address - Street 2:SUITE A
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2402
Practice Address - Country:US
Practice Address - Phone:630-665-9155
Practice Address - Fax:630-665-5557
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL552500Medicare ID - Type UnspecifiedWOL MEDICARE NUMBER
ILU67896Medicare UPIN