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NPI Code Detail

MEDICARE: JENNIFER RIEDEL

MEDICARE:   JENNIFER  RIEDEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician125087939IL

General Provider Information

NPI Number : 1114754793
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER RIEDEL
Provider Business Mailing Address
First Line : 5841 S MARYLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60637-1443
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2650 RIDGE AVE STE 1304
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number : 847-570-2700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2024
Last Update Date : 06/10/2026

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Directions to “ JENNIFER RIEDEL ” Practice Location

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