MEDICARE: DR. CYNTHIA JAFFE DC-NP-C

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
1	363L00000X	Nurse Practitioner	03154	NM
2	363L00000X	Nurse Practitioner	10147917-4405	UT
3	111NI0900X	Internist Chiropractor	038008595	IL
4	363L00000X	Nurse Practitioner	60737810	WA
5	363L00000X	Nurse Practitioner	95007523	CA
6	363L00000X	Nurse Practitioner	NP5541	MN
7	363LF0000X	Family Nurse Practitioner	AP9866	AZ
8	363LF0000X	Family Nurse Practitioner	209009692	IL

General Provider Information

NPI Number	:	1699854778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA JAFFE DC-NP-C

Provider Business Mailing Address
First Line	:	28763 W MAIN ST
Second Line	:
City	:	BARRINGTON
State	:	IL
Zip	:	60010-1829
Country	:	US
Telephone Number	:	847-830-8748
Fax Number	:

Provider Business Practice Location Address
First Line	:	3940 N RAVENSWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-2420
Country	:	US
Telephone Number	:	847-830-8748
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	06/09/2020

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