MEDICARE: JENNIFER MALLORY LYNCH MD

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	208000000X	Pediatrics Physician	036115293	IL

General Provider Information

NPI Number	:	1942242078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MALLORY LYNCH MD

Provider Business Mailing Address
First Line	:	3040 W SALT CREEK LN
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1069
Country	:	US
Telephone Number	:	847-870-4780
Fax Number	:	847-483-7447

Provider Business Practice Location Address
First Line	:	1786 MOON LAKE BLVD STE 201
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-1067
Country	:	US
Telephone Number	:	847-884-7550
Fax Number	:	847-884-7510

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	03/22/2021

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