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General NPI Number Information
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NPI Number | 1003867409
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Entity Type | Individual
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Provider Name | JENNIFER M CHEVALIER MD
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Gender | Female
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 01/09/2018
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Provider Practice Location Address
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Address Line | 13950 W CAPITOL DR STE 200
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City | BROOKFIELD
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State | WI
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Zip | 53005-2441
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Country | US
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Telephone | 262-781-3065
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Fax | 262-781-3835
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Provider Business Mailing Address
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Address Line | 9000 W WISCONSIN AVE # MS 958
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City | MILWAUKEE
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State | WI
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Zip | 53226-4874
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Country | US
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Telephone | 414-266-7615
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Fax | 414-266-6238
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 42630
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 42630-20
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License Number State | WI
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