MS. JENNA SPAETH (NPI# 1669857512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669857512 |
| Entity Type | Individual |
| Full Name | MS. JENNA SPAETH |
| Credential | PA-C |
| Practice Address |
3880 Salem Lake Dr F Long Grove IL 60047-5292 |
| Practice Telephone | 8477192220 |
| Practice Fax Number | 8477192265 |
| Mailing Telephone | 8477192220 |
| Mailing Fax Number | 8477192265 |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-12-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085.005554 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3880 SALEM LAKE DR F |
| City | LONG GROVE |
| State | IL |
| Zip Code | 60047-5292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265437230 | Robert J Longo | Internal Medicine | 3880 Salem Lake Dr, Ste F, Long Grove, IL 60047-5292 | 2005-06-16 |
| 1063998094 | Kelsey Lynn Freund | Physician Assistant | 3880 Salem Lake Dr, Long Grove, IL 60047 | 2018-07-12 |
| 1891240636 | Erin Marie Daly | Nurse Practitioner | 3880 Salem Lake Dr, Ste F, Long Grove, IL 60047-5292 | 2016-08-22 |
| 1518393388 | Dioma Udeoji | Internal Medicine | 3880 Salem Lake Dr, F, Long Grove, IL 60047-5292 | 2013-09-24 |
| 1821439316 | Roland Mariusz Kitlas | Internal Medicine | 3880 Salem Lake Dr, Suite F, Long Grove, IL 60047-5292 | 2013-07-11 |
| 1881034809 | Mahjabeen Khan | Internal Medicine | 3880 Salem Lake Dr, Suite F, Long Grove, IL 60047-5292 | 2013-07-05 |
| 1639519309 | Mazin Fattouhi | Internal Medicine | 3880 Salem Lake Dr, F, Long Grove, IL 60047-5292 | 2013-06-26 |
| 1649619768 | Melissa Long | Nurse Practitioner | 3880 Salem Lake Dr, F, Long Grove, IL 60047-5292 | 2013-06-21 |
| 1164868691 | Ava Mastny | Internal Medicine | 3880 Salem Lake Dr, F, Long Grove, IL 60047-5292 | 2013-05-10 |
| 1225370836 | Saba Siddiqui | Internal Medicine | 3880 Salem Lake Dr, Suite F, Long Grove, IL 60047-5292 | 2013-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871142547 | Terry Solberg | Technician | 25 Robin Crest Rd, Hawthorn Woods, IL 60047 | 2019-09-05 |
| 1073083614 | Cody Colleen Todd | Counselor | 21361 W Brandon Rd, Kildeer, IL 60047 | 2018-11-27 |
| 1861983694 | Ahmad Family Primary Care, S.c. | Family Medicine | 350 Surryse Rd Ste 240, Lake Zurich, IL 60047 | 2018-05-29 |
| 1508371972 | Joy Anne Margolis | Speech-Language Pathologist | 4151 Robert Parker Coffin Rd, Long Grove, IL 60047 | 2017-12-07 |
| 1982118576 | Stephanie Marie Luebbe | Specialist/Technologist | 30 Seneca Ave W, Hawthorn Woods, IL 60047 | 2017-11-19 |
| 1447785498 | Kayla Stavnes | Student in an Organized Health Care Education/Training Program | 23537 N Garden Ln, Lake Zurich, IL 60047 | 2017-04-27 |
| 1104366491 | Lindsay Pearlman & Associates | Psychologist | 4160 Rte 83, Suite 307, Long Grove, IL 60047 | 2017-03-06 |
| 1164969929 | Lauren Christine Hallerud | Counselor | 4180 Il-83, Suite 10, Long Grove, IL 60047 | 2017-01-31 |
| 1790220820 | Long Grove Center for Emotional Health LLC | Counselor | 4180 Rfd, Suite 10, Long Grove, IL 60047 | 2016-12-28 |
| 1063960276 | Mars Healthcare LLC | Clinic/Center | 721 W Highway 22nd, Lake Zurich, IL 60047 | 2016-09-16 |
| Find all providers in zip 60047 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942788922 | Shreya Vasavada | Physician Assistant | 3880 Salem Lake Dr Ste F, Long Grove, IL 60047-5292 | 2018-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
| 1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
| 1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
| 1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
| 1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
| Find all providers with the same taxonomy | ||||
| City | LONG GROVE |
| Zip Code | 60047 |
Please comment or provide details below to improve the information on MS. JENNA SPAETH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.