Individual
JENNIFER C WICKLATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
111 W JACKSON BLVD STE 1700, CHICAGO, IL 60604-3597
(888) 731-8994
Mailing address
111 W JACKSON BLVD STE 1700, CHICAGO, IL 60604-3597
(888) 731-8994
(833) 775-1861
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.024499
IL
363LF0000X
Family Nurse Practitioner
11015667
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063184026
NPI
IL
Enumeration date
09/29/2021
Last updated
05/07/2025
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