Provider Demographics
NPI:1033625025
Name:TAYLOR, JESSICA (APN/CNS, CEN)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APN/CNS, CEN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 W CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-2408
Mailing Address - Country:US
Mailing Address - Phone:224-829-8798
Mailing Address - Fax:
Practice Address - Street 1:44 W CENTER AVE
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-2408
Practice Address - Country:US
Practice Address - Phone:224-829-8798
Practice Address - Fax:224-829-8798
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.015646163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209.015646OtherAPN LICENSE NUMBER