Provider Demographics
NPI:1538156567
Name:CHLUDZINSKI, JENNIFER A (APN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:CHLUDZINSKI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:TOLJANIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2007 95TH ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8459
Mailing Address - Country:US
Mailing Address - Phone:630-646-6920
Mailing Address - Fax:630-646-5823
Practice Address - Street 1:2007 95TH ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8459
Practice Address - Country:US
Practice Address - Phone:630-646-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209004827207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK02841Medicare PIN
ILK45761Medicare PIN
ILP00067311Medicare PIN
ILK41359Medicare PIN
ILK41360Medicare PIN
ILK26578Medicare PIN