Individual
MRS. JACQUELINE COFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
901 E SIBLEY BLVD, SOUTH HOLLAND, IL 60473-1166
(773) 233-4100
Mailing address
4102 W GLADYS AVE, CHICAGO, IL 60624-2729
(773) 807-8036
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
IL
363LF0000X
Family Nurse Practitioner
Primary
041246157
IL
363LF0000X
Family Nurse Practitioner
28283705A
IN
Other
Enumeration date
06/28/2021
Last updated
03/07/2025
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