Individual
JESSICA R MISKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
INDEPENDENT APN
Contact information
Practice address
218 W MADISON ST, OTTAWA, IL 61350-2819
(815) 431-1122
(877) 503-2851
Mailing address
218 W MADISON ST, OTTAWA, IL 61350-2819
(815) 431-1122
(877) 503-2851
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
209009286
IL
207QA0401X
Addiction Medicine (Family Medicine) Physician
209009286
IL
261QM1300X
Multi-Specialty Clinic/Center
277000895
IL
363LF0000X
Family Nurse Practitioner
209009286
IL
363LF0000X
Family Nurse Practitioner
Primary
277000895
IL
363LP2300X
Primary Care Nurse Practitioner
209009286
IL
363LP2300X
Primary Care Nurse Practitioner
277000895
IL
363LW0102X
Women's Health Nurse Practitioner
277000895
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041326705
REGISTERED NURSE
IL
01
—
14D2107071
CLIA EXP 1/5/22
IL
01
—
1710256631
NPI
IL
01
—
1750756979
GROUP NPI
IL
01
—
2011016696
BOARD CERTIFIED BY ANCC
IL
01
—
277000895
FULL PRACTICE AUTHORITY APN
IL
Enumeration date
12/21/2011
Last updated
02/04/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us