Individual
MS. JESSICA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN/CNS, CEN
Contact information
Practice address
44 W CENTER AVE, LAKE BLUFF, IL 60044-2408
(224) 829-8798
(224) 829-8798
Mailing address
44 W CENTER AVE, LAKE BLUFF, IL 60044-2408
(224) 829-8798
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
209.015646
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.015646
APN LICENSE NUMBER
IL
Enumeration date
12/28/2017
Last updated
06/16/2018
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