Provider Demographics
NPI:1063599744
Name:NG, JENNIE S (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIE
Middle Name:S
Last Name:NG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:JENNIE
Other - Middle Name:NG
Other - Last Name:HSIEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:2 TRANSAM PLAZA DR STE 100
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4289
Practice Address - Country:US
Practice Address - Phone:630-717-2600
Practice Address - Fax:630-932-3437
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-111351207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0361111351Medicaid
IL1622295OtherBCBS