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General NPI Number Information
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NPI Number | 1578811873
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Entity Type | Organization
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Legal Business Name | CYNTHIA E JAFFE, LTD
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Dates
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Enumeration Date | 08/17/2012
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 1251 SHERMER RD
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City | NORTHBROOK
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State | IL
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Zip | 60062-4599
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Country | US
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Telephone | 312-939-5960
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Fax | 312-896-9394
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Provider Business Mailing Address
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Address Line | 1215 DARYL LN
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City | NORTHBROOK
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State | IL
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Zip | 60062-4610
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Country | US
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Telephone | 847-830-8748
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Fax | 312-896-9394
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Authorized Official
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Title or Position | PRESIDENT
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Name | CYNTHIA JAFFE
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Credential | NP-C
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Telephone | 847-830-8748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209009692
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License Number State | IL
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