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NPI Code Detail

MEDICARE: JENNA BACERRA OD

MEDICARE: JENNA BACERRA OD
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
1152W00000XOptometrist046.011997IL

General Provider Information

NPI Number : 1659263259
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA BACERRA OD
Provider Business Mailing Address
First Line : 121 W 63RD ST # D205
Second Line :
City : WESTMONT
State : IL
Zip : 60559-2796
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8525 S HARLEM AVE
Second Line :
City : BURBANK
State : IL
Zip : 60459-2293
Country : US
Telephone Number : 708-599-0050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2025
Last Update Date : 07/17/2025

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Directions to “ JENNA BACERRA OD” Practice Location

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