Healthcare Provider Details

I. General information

NPI: 1023577236
Provider Name (Legal Business Name): JENNIFER MICHELLE SATAR DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 E SHAWNEE DR STE 4
MURPHYSBORO IL
62966-7072
US

IV. Provider business mailing address

PO BOX 3988
CARBONDALE IL
62902-3988
US

V. Phone/Fax

Practice location:
  • Phone: 618-565-8632
  • Fax: 618-565-8669
Mailing address:
  • Phone: 618-457-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number036181832
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: