Individual
JESSICA SHANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
676 N SAINT CLAIR ST STE 14-044, CHICAGO, IL 60611-2927
(312) 908-8163
(312) 908-8163
Mailing address
676 N SAINT CLAIR ST STE 14-044, CHICAGO, IL 60611-2927
(312) 908-8163
(312) 908-8163
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209026391
IL
363LA2100X
Acute Care Nurse Practitioner
209.026391
IL
Other
Enumeration date
04/23/2024
Last updated
10/02/2024
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