Individual
JENNY MOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9977 WOODS DR STE 165, SKOKIE, IL 60077-1057
(224) 364-2273
Mailing address
9977 WOODS DR STE 165, SKOKIE, IL 60077-1057
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041441989
IL
363L00000X
Nurse Practitioner
Primary
209029218
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209029218
DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
09/06/2023
Last updated
09/16/2024
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