Individual
JESSICA LIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1165 N CLARK ST, CHICAGO, IL 60610-2702
(866) 389-2727
Mailing address
1165 N CLARK ST, CHICAGO, IL 60610-2702
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209022156
IL
Other
Enumeration date
11/11/2020
Last updated
11/06/2025
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