MEDICARE: MRS. JENNIFER N. HINMAN

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	133V00000X	Registered Dietitian		IL

General Provider Information

NPI Number	:	1942396544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER N. HINMAN

Provider Business Mailing Address
First Line	:	317 HANNIBAL STREET
Second Line	:
City	:	TREMONT
State	:	IL
Zip	:	61568
Country	:	US
Telephone Number	:	309-449-4332
Fax Number	:	309-449-5441

Provider Business Practice Location Address
First Line	:	107 TREMONT
Second Line	:
City	:	HOPEDALE
State	:	IL
Zip	:	61747-0267
Country	:	US
Telephone Number	:	309-449-3321
Fax Number	:	309-449-5441

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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