STEPHEN H JENNISON M.D. NPI 1043391766

NPI Information

NPI: 1043391766
Provider Name: STEPHEN H JENNISON, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
619 E MASON ST
SUITE 4P57
SPRINGFIELD, IL
ZIP 62701
Phone: (217) 788-0706
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Stephen H Jennison, M.D. is a specialist in Springfield, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Stephen H Jennison, M.D. NPI is 1043391766. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

619 E MASON ST
SUITE 4P57
SPRINGFIELD, IL
ZIP 62701-034
Phone: (217) 788-0706
Fax: (217) 525-2535

The enumeration date for this NPI number is 10/18/2006 and was last updated on 6/2/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		036-091807	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	L92313	MEDICARE PIN	ILLINOIS
2	060031123	OTHER	ILLINOIS	RAILROAD
3	F32472	MEDICARE UPIN	ILLINOIS
4	L66754	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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