Individual
EMMA CONCEPCION ICO JOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15300 WEST AVE STE 313, ORLAND PARK, IL 60462-4687
(708) 923-7878
(708) 923-7888
Mailing address
9410 ALBANY CT, ORLAND PARK, IL 60467-5634
(773) 954-0334
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209028504
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209028504
IL
Other
Enumeration date
01/18/2024
Last updated
02/18/2026
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