Provider Demographics
NPI:1598775157
Name:FEI, JENNY HONGYAN (DMD)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:HONGYAN
Last Name:FEI
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:FEI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:102 S RIDGELAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2920
Mailing Address - Country:US
Mailing Address - Phone:708-386-2610
Mailing Address - Fax:
Practice Address - Street 1:102 S RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2920
Practice Address - Country:US
Practice Address - Phone:773-779-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190252271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice