Healthcare Provider Details

I. General information

NPI: 1053577650
Provider Name (Legal Business Name): JENNIFER LYNN MCNEER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2008
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 N CHILDRENS PLZ # 30
CHICAGO IL
60614-3363
US

IV. Provider business mailing address

2300 N CHILDRENS PLZ # 30
CHICAGO IL
60614-3363
US

V. Phone/Fax

Practice location:
  • Phone: 773-880-4562
  • Fax: 773-880-3053
Mailing address:
  • Phone: 773-880-4562
  • Fax: 773-880-3053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number036114582
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: