Jenie Nepomuceno, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

036082689 Issued in IL

Practice address

4309 W Medical Center Dr Ste B207
McHenry, IL 60050-8439

Phone

(888) 220-6432

Fax

(630) 654-4253

NPI assigned

Dec 7, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063843670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE A102",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508436",
            "telephone_number": "815-338-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE B207",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508439",
            "telephone_number": "888-220-6432",
            "fax_number": "630-654-4253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22093 N Countryside Ln",
            "address_purpose": "LOCATION",
            "city": "Barrington",
            "state": "IL",
            "postal_code": "600102414",
            "country_code": "US",
            "telephone_number": "847-921-8735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4309 W Medical Center Dr Ste A102",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600508436",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEPOMUCENO",
        "first_name": "JENIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036082689",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036082689",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036082689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036082689",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delaney Joy Nelson
• Kaitlynn Nelson
• Lori Ann Nelson, LCPC, CSADC
• Dawn Nendze
• Daniel Joseph Nepomuceno, M.D.
• Danielle Nesheiwat
• Austin James Neuhaus
• Arminda Jean Neukirch
• Neuroclinic and Assessments, LLC
• Maria G. Nevarez

• Infectious Disease Physician in McHenry, IL
• Providers in McHenry, IL by specialty
• Infectious Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.