Individual
JODI A BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN RN
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-4107
Mailing address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-4107
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041261961
IL
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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