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General NPI Number Information
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NPI Number | 1568099380
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Entity Type | Individual
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Provider Name | BIANCA JENKINS MD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 3245 N HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60657-3419
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Country | US
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Telephone | 773-388-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 3245 N HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60657-3419
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Country | US
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Telephone | 773-388-1600
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.166251
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number | 125.076810
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 125.076810
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number | 125.076810
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 125.076810
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 125076810
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License Number State | IL
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