Provider Demographics
NPI:1275620718
Name:CHERIKOS, JESSICA E (CNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:E
Last Name:CHERIKOS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:E
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:1725 W HARRISON ST.
Mailing Address - Street 2:SUITE 308
Mailing Address - City:CHCIAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-942-9472
Mailing Address - Fax:312-942-9198
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:SUITE 308
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-942-9472
Practice Address - Fax:312-942-9198
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILAPN209004808363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner