Organization
JEP HEALTHCARE PROVIDER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH ESCOBAR APN (PRESIDENT)
(847) 287-9102
Entity
Organization
Contact information
Practice address
1330 KETTERING RD, MUNDELEIN, IL 60060-5364
(847) 287-9102
(847) 388-4711
Mailing address
1330 KETTERING RD, MUNDELEIN, IL 60060-5364
(847) 388-4711
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209009807
IL
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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