MARY-JENNELLE GUEVARA NPI 1225397268

NPI Information

NPI: 1225397268
Provider Name: MARY-JENNELLE GUEVARA
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Organization: PRIMA MEDICAL PRACTICES INC

PECOS Registration: Yes

Address:
1875 DEMPSTER ST
SUITE 180
PARK RIDGE, IL
ZIP 60068
Phone: (847) 897-9010
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Mary-jennelle Guevara is an acute care nurse practitioner in Park Ridge, IL with 13 years of experience. Mary-jennelle Guevara NPI is 1225397268. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduation Year:2011

The provider's business location address is:

1875 DEMPSTER ST
SUITE 180
PARK RIDGE, IL
ZIP 60068-186
Phone: (847) 897-9010

The NPI 1225397268 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/11/2012 and was last updated on 2/19/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	209009523	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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