Individual
MS. PATRICIA JEANTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
10448 S PULASKI RD STE 6, OAK LAWN, IL 60453-4895
(773) 449-1927
(708) 570-0434
Mailing address
10448 S PULASKI RD STE 6, OAK LAWN, IL 60453-4895
(773) 449-1927
(708) 570-0434
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277001117
IL
363LF0000X
Family Nurse Practitioner
209008720
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL7356
PTAN
IL
Enumeration date
05/10/2011
Last updated
03/02/2026
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