MS. JENNA SPAETH PA-C
NPI 1669857512
Physician Assistant - Medical in Long Grove, IL

Q: What is Jenna Spaeth's NPI number?

The NPI number for Jenna Spaeth is 1669857512. It was assigned to this individual provider in the NPPES registry on July 21, 2015.

Q: What is Jenna Spaeth's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Jenna Spaeth was last updated on December 2, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 21, 2015PECOS Enrolled

3880 SALEM LAKE DR, F, LONG GROVE, IL 60047(847) 719-2220(847) 719-2265 Get Directions Write a Review

NPPES record last updated: December 2, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Ms. Jenna Spaeth Pa-c NPPES

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

MS. JENNA SPAETH PA-C (NPI 1669857512) is an individual medical provider in Long Grove, Illinois, licensed in Illinois (085.005554) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669857512

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMS. JENNA SPAETHCredential: PA-C

Location Address3880 SALEM LAKE DR, FLong Grove, IL 60047-5292

Mailing Address3880 Salem Lake Dr, FLong Grove, IL 60047-5292 · (847) 719-2220 · Fax (847) 719-2265

Phone(847) 719-2220

Fax(847) 719-2265

Sole ProprietorNo

Enumeration DateJuly 21, 2015

Last NPPES UpdateDecember 2, 2015

✔ NPI 1669857512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in IL · 085.005554

3880 SALEM LAKE DR, Long Grove, IL 60047

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Other Identifiers 1

Medicare PINF400258799,F40025880IL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Jenna Spaeth Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.