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Individual

JACK ALAN KAMENSKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSN, RN, FNP-BC

Contact information

Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5580
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209020706
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
209-020706
IL

Other

Enumeration date
01/15/2020
Last updated
02/26/2025
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