Provider Demographics
NPI:1124396221
Name:JURETSCHKE, LINDA J (PHD, APN/NNP-BC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:J
Last Name:JURETSCHKE
Suffix:
Gender:F
Credentials:PHD, APN/NNP-BC
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Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:RUSSO, 5TH FLOOR, NEONATAL
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-216-8261
Mailing Address - Fax:708-216-4125
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:RUSSO, 5TH FLOOR, NEONATAL
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-8261
Practice Address - Fax:708-216-4125
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209-000173363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care