Individual
JENNIFER MAINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3348 W 87TH ST, CHICAGO, IL 60652-3767
(773) 776-4471
(773) 564-3510
Mailing address
30 W MONROE ST STE 1200, CHICAGO, IL 60603-2420
(312) 733-9730
(773) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209015853
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209015853
NP LICENSE NUMBER
IL
Enumeration date
08/23/2017
Last updated
08/23/2017
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