Pendergast, Jaynee Ellise

Pendergast, Jaynee Ellise is an individual health care provider with primary practice located at 1345 Edwards St Ste 2 , Morris IL 60450-1692. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Pendergast, Jaynee Ellise can be contacted via phone (815) 942-1421.

Contact Information

Primary practice address
1345 Edwards St Ste 2 Morris IL 60450-1692
Phone: (815) 942-1421
Fax: (815) 488-2033
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 125066219 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036144109 Illinois

Profile Details

NPI number 1235519901
LBN Legal business name Pendergast, Jaynee Ellise
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2015
Last updated Jun 24th, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235519901 NPPES
Illinois Other 036.144109 IL LICENSE

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