Healthcare Provider Details

I. General information

NPI: 1619976560
Provider Name (Legal Business Name): JENNIFER L SCHENING D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 S MCLEAN BLVD STE B
SOUTH ELGIN IL
60177-1822
US

IV. Provider business mailing address

107 S MCLEAN BLVD STE B
SOUTH ELGIN IL
60177-1822
US

V. Phone/Fax

Practice location:
  • Phone: 847-695-9900
  • Fax: 847-695-9989
Mailing address:
  • Phone: 847-695-9900
  • Fax: 847-695-9989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036104509
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: