1447324702 NPI number — MRS. JENNIFER ELLEN DUMRAUF RN, APN, C-CNS

Table of content: MRS. JENNIFER ELLEN DUMRAUF RN, APN, C-CNS (NPI 1447324702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447324702 NPI number — MRS. JENNIFER ELLEN DUMRAUF RN, APN, C-CNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUMRAUF
Provider First Name:
JENNIFER
Provider Middle Name:
ELLEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, APN, C-CNS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BECKER
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447324702
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
880 W CENTRAL RD
Provider Second Line Business Mailing Address:
SUITE 5000
Provider Business Mailing Address City Name:
ARLINGTON HEIGHTS
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60005-2355
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-618-3800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2050 CLAIRE CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENVIEW
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60025-7635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-467-7423
Provider Business Practice Location Address Fax Number:
847-556-1622
Provider Enumeration Date:
11/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364S00000X , with the licence number:  209-005025 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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