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Individual

MR. JIMMUEL PLAZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN, APN, FNP-BC

Contact information

Practice address
676 N ST. CLAIR SUITE 800, NORTHWESTERN MEDICAL GROUP, CHICAGO, IL 60611
(773) 988-3224
Mailing address
5648 N RIDGE AVE APT 1W, CHICAGO, IL 60660-5521
(773) 988-3224

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209012400
IL

Other

Enumeration date
03/11/2015
Last updated
03/11/2015
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