Provider Demographics
NPI:1053547398
Name:HOWARD, JEAN ANN (DO)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:ANN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 N ELM ST
Mailing Address - Street 2:STE 207
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3635
Mailing Address - Country:US
Mailing Address - Phone:630-323-1558
Mailing Address - Fax:630-323-2930
Practice Address - Street 1:908 N ELM ST
Practice Address - Street 2:STE 207
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3635
Practice Address - Country:US
Practice Address - Phone:630-323-1558
Practice Address - Fax:630-323-2930
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125055974390200000X
IL036128687207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program