Connolly, Jeanine
Connolly, Jeanine is an individual health care provider with primary practice located at 2320 High St , Blue Island IL 60406-2426. She recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as her primary health care specialty. Connolly, Jeanine can be contacted via phone (708) 388-5500.Contact Information
Primary practice address
2320 High St
Blue Island IL 60406-2426
Phone: (708) 388-5500
Fax: (708) 388-5672
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 036104880 | Illinois |
Profile Details
| NPI number | 1346203064 |
|---|---|
| LBN Legal business name | Connolly, Jeanine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 11th, 2006 |
| Last updated | Jan 24th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346203064 | NPPES |
| Illinois | Other | P00156797 | RAILROAD MEDICARE |
| Illinois | MEDICAID | 036104880 | RAILROAD MEDICARE |
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