Individual
SONGQUAN JIANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
860 FOREST AVE UNIT A, EVANSTON, IL 60202-2473
(773) 273-5453
Mailing address
860 FOREST AVE UNIT A, EVANSTON, IL 60202-2473
(773) 273-5453
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209013070
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2014006230
ANCC
IL
05
—
209013070
—
IL
Enumeration date
07/09/2018
Last updated
06/29/2023
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