Jene'S LTD Boutique

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

C36319 Issued in IL

Legal business name

JENE'S LTD BOUTIQUE

Practice address

4700 N. University
SPC 93 Metro Center
Peoria, IL 61614-5849

Phone

(309) 694-7720

Fax

(309) 694-7748

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Euviva Jene Alcaraz

Title

President (Owner)

Phone

(309) 694-7720

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252454400000",
    "number": "1386793438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2545",
            "address_2": "312 ILLINI DRIVE",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "61611",
            "telephone_number": "309-694-7720",
            "fax_number": "309-694-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N. UNIVERSITY",
            "address_2": "SPC 93 METRO CENTER",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145849",
            "telephone_number": "309-694-7720",
            "fax_number": "309-694-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENE'S LTD BOUTIQUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2009-09-09",
        "status": "A",
        "authorized_official_last_name": "ALCARAZ",
        "authorized_official_first_name": "EUVIVA",
        "authorized_official_middle_name": "JENE",
        "authorized_official_title_or_position": "PRESIDENT (OWNER)",
        "authorized_official_telephone_number": "309-694-7720"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "C36319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Jefford, DNP, APN
• Talya Marie Jeffrey, DO
• James Murray Jeffries III, MD
• Charity Thompson Jeffs, CD(DONA)
• Adam Kyle Jelinek, PA-C
• Jenecsis Castro-Skoglund SC
• Ann Jenkins, MD
• Janessa Michele Jenkins, APN
• Leo Chapin Jennetten, MD
• Mark Jennings, MD

• Durable Medical Equipment & Medical Supplies in Peoria, IL
• Providers in Peoria, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.