Look up the most recent NPI and PECOS records

Jennifer Marsidi

Internal Medicine

Allopathic & Osteopathic Physicians

1645 W Jackson Blvd Ste 215, Chicago, IL 60612-3227

PECOS Enrollment

Based on the most recent information from CMS, provider Jennifer Marsidi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1275713588
Provider Type
Individual
Full Name
Marsidi, Jennifer
Title
Ms.
Credential
DO

Gender
Female
Sole Proprietor
No
Enumeration Date
11/5/2007
Last Updated
5/24/2021

Contact Information

Practice Location

1645 W Jackson Blvd Ste 215, Chicago, IL 60612-3227

(312) 942-3254

Unlisted Fax

Mailing Location

1645 W Jackson Blvd Ste 215, Chicago, IL 60612-3227

(312) 942-3254

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 125.077691 Illinois
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License 125.077691 Illinois
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License AP30007951 Washington
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Jennifer Marsidi

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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Ilelaboye, Ayodeji Israel

Quevedo Ramirez, Andres

Almouradi, Tarek

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Rasool, Faizan