MEDICARE: JEFFREY L OLEJNIK LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC0359	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	06932015	OTHER	IL	BLUE CROSS BLUE SHIELD
3	567115	OTHER	IL	HEALTHLINK

General Provider Information

NPI Number	:	1053351874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY L OLEJNIK LLC

Provider Business Mailing Address
First Line	:	PO BOX 1977
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62705-1977
Country	:	US
Telephone Number	:	217-544-6464
Fax Number	:	217-757-6021

Provider Business Practice Location Address
First Line	:	1600 W WALNUT ST
Second Line	:
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-1136
Country	:	US
Telephone Number	:	217-243-5930
Fax Number	:	217-243-8073

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	COURTNEY MCMAHAN
Credential	:
Telephone Number	:	217-243-5930

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	08/22/2020

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Directions to “JEFFREY L OLEJNIK LLC ” Practice Location

Language	Start Address	Practice Location

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