Individual
MRS. JENNIFER C NIEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3880 SALEM LAKE DR STE F, LONG GROVE, IL 60047-5292
(847) 719-2220
(847) 719-2265
Mailing address
3880 SALEM LAKE DR STE F, LONG GROVE, IL 60047-5292
(847) 719-2220
(847) 719-2265
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209013566
IL
363LA2200X
Adult Health Nurse Practitioner
Primary
209013566
IL
363LF0000X
Family Nurse Practitioner
209013566
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209013566
—
IL
01
—
MN3825849
DEA
IL
Enumeration date
12/30/2015
Last updated
12/07/2025
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