Provider Demographics
NPI:1043481203
Name:SCHNELL, JENNIFER (APN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SCHNELL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 N STATE ROUTE 50
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-4890
Mailing Address - Country:US
Mailing Address - Phone:815-370-4941
Mailing Address - Fax:815-468-3151
Practice Address - Street 1:2070 N IL 50
Practice Address - Street 2:SUITE 500
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-3233
Practice Address - Country:US
Practice Address - Phone:815-370-4941
Practice Address - Fax:779-236-4095
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-242124363L00000X
IL209002525363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner