Healthcare Provider Details

I. General information

NPI: 1417475591
Provider Name (Legal Business Name): JENNIFER LI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 N HIGHLAND AVE
AURORA IL
60506-1449
US

IV. Provider business mailing address

1325 N HIGHLAND AVE
AURORA IL
60506-1449
US

V. Phone/Fax

Practice location:
  • Phone: 312-731-3593
  • Fax: 312-731-3593
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036.181465
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: