Individual
JENNY YOHANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1600 DEMPSTER ST STE 120, PARK RIDGE, IL 60068-1171
(847) 299-7888
Mailing address
1277 E THACKER ST APT 203, DES PLAINES, IL 60016-8617
(815) 295-2468
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
041388347
IL
363LF0000X
Family Nurse Practitioner
Primary
209022043
IL
Other
Enumeration date
09/16/2020
Last updated
09/23/2020
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