Individual
JESSICA DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
5841 S MARYLAND AVE # MC-2026, CHICAGO, IL 60637-1443
(773) 702-3794
Mailing address
7026 WILSON TER, MORTON GROVE, IL 60053-1236
(773) 592-3096
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209018583
IL
Other
Enumeration date
03/30/2019
Last updated
07/28/2019
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