LEO CHAPIN JENNETTEN MD
NPI 1538819024
Student in an Organized Health Care Education/Training Program in Peoria, IL

Active since March 27, 2022PECOS Enrolled
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2000 Get Directions Write a Review

NPPES record last updated: March 27, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Leo Chapin Jennetten Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEO CHAPIN JENNETTEN MD (NPI 1538819024) is an individual student in an organized health care education/training program in Peoria, Illinois and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2022).

NPPES Registry Identity

NPI1538819024
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameLEO CHAPIN JENNETTENCredential: MD
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address2118 W Laura AveWest Peoria, IL 61604-5146 · (309) 369-6639
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2022
Enumeration DateMarch 27, 2022
NPPES CertifiedMarch 27, 2022
NPI 1538819024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
530 NE GLEN OAK AVE, Peoria, IL 61637

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Leo Chapin Jennetten Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8022580828
PECOS Enrollment IDI20260612000682
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Neurology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leo Jennetten's NPI number?

The NPI number for Leo Jennetten is 1538819024. It was assigned to this individual provider in the NPPES registry on March 27, 2022.

Where is Leo Jennetten located?

Leo Jennetten practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-2000.

What is Leo Jennetten's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Leo Jennetten enrolled in Medicare?

Yes. Leo Jennetten is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Leo Jennetten was last updated on March 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.