Physician Compare National (NPI:1730509159)

HEALTHCARE PROVIDER: JENNIFER THERY

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1730509159
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3476777566
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140611000511
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	THERY
	Individual professional last name
Provider First Name	JENNIFER
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	11191 IL ROUTE 185
	Group Practice or individual's line 1 address
City	HILLSBORO
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	620492664
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	141332
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HILLSBORO AREA HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y