Provider Demographics
NPI:1588780795
Name:BARTHEL, JENESS MICHELE (MD)
Entity type:Individual
Prefix:DR
First Name:JENESS
Middle Name:MICHELE
Last Name:BARTHEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENESS
Other - Middle Name:MICHELE
Other - Last Name:CONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2801 LAKESIDE DR STE 209
Mailing Address - Street 2:
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-1271
Mailing Address - Country:US
Mailing Address - Phone:847-562-1410
Mailing Address - Fax:847-562-0830
Practice Address - Street 1:1435 N RANDALL RD
Practice Address - Street 2:STE 309
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2300
Practice Address - Country:US
Practice Address - Phone:847-741-7990
Practice Address - Fax:847-741-8099
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081592390200000X
IL036.119017207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program