JEP HEALTHCARE PROVIDER LLC NPI 1730582990

NPI Information

NPI: 1730582990
Provider Name: JEP HEALTHCARE PROVIDER, LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
1330 KETTERING RD
MUNDELEIN, IL
ZIP 60060
Phone: (847) 287-9102
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JEP HEALTHCARE PROVIDER, LLC is a family nurse practitioner in Mundelein, IL. JEP HEALTHCARE PROVIDER, LLC NPI is 1730582990. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1330 KETTERING RD
MUNDELEIN, IL
ZIP 60060-364
Phone: (847) 287-9102
Fax: (847) 388-4711

The provider's authorized official is Joseph Escobar .
The authorized official title is President and has the following contact phone number (847) 287-9102.

The enumeration date for this NPI number is 10/2/2014 and was last updated on 10/2/2014.

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	363LF0000X	Nurse Practitioner	Family	209009807	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: 4/28/2024

NPI Synchronization or Removal

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