Individual
JENELLE KUBIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, APNP
Contact information
Practice address
1000 BURR RIDGE PKWY STE 201, BURR RIDGE, IL 60527-0864
(312) 818-4650
Mailing address
PO BOX 639295 DEPT 93394, CINCINNATI, OH 45263-9295
(248) 266-4200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
220319-30
WI
363LF0000X
Family Nurse Practitioner
Primary
209028017
IL
Other
Enumeration date
09/27/2018
Last updated
05/20/2024
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