Individual
JENNIFER RACINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3718 N ASHLAND AVE, CHICAGO, IL 60613-4793
(773) 327-9900
(773) 327-0589
Mailing address
1601 N WELLS ST, CHICAGO, IL 60614-6001
(800) 323-8622
(224) 225-0376
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2090111171
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209011171
LICENSE
IL
Enumeration date
01/31/2014
Last updated
04/20/2022
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