Healthcare Provider Details

I. General information

NPI: 1386084101
Provider Name (Legal Business Name): JAIME RENEE PALMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAIME RENEE NIELSEN

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W TAYLOR ST
CHICAGO IL
60612-7232
US

IV. Provider business mailing address

722 W MAXWELL ST
CHICAGO IL
60607-5002
US

V. Phone/Fax

Practice location:
  • Phone: 866-600-2273
  • Fax:
Mailing address:
  • Phone: 312-996-2901
  • Fax: 312-996-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036153895
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: