Individual
JILL P PANKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
124 HARRISON ST, BARRINGTON, IL 60010-3007
(847) 381-7618
(847) 381-9198
Mailing address
3600 W FULLERTON AVENUE, CHICAGO, IL 60647
(773) 782-2800
(773) 782-5042
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209001706
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209001706
APN LICENSE
IL
01
—
309002557
RN LICENSE
IL
Enumeration date
03/29/2007
Last updated
09/02/2016
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