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General NPI Number Information
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NPI Number | 1790016004
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Entity Type | Individual
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Provider Name | JOWELLA REAL PINEDA M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 1941 ROHLWING RD
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City | ROLLING MEADOWS
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State | IL
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Zip | 60008-1338
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Country | US
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Telephone | 847-618-0850
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Fax | 847-618-0859
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Provider Business Mailing Address
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Address Line | 1941 ROHLWING RD
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City | ROLLING MEADOWS
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State | IL
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Zip | 60008-1338
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Country | US
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Telephone | 847-618-0850
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Fax | 847-618-0859
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301103257
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 036144125
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036144125
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License Number State | IL
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