Provider Demographics
NPI:1407908015
Name:STOOPS, JILL ANN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ANN
Last Name:STOOPS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 19639
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62794-9639
Mailing Address - Country:US
Mailing Address - Phone:217-545-8000
Mailing Address - Fax:844-470-2486
Practice Address - Street 1:2833 S GRAND AVE E STE 100
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-2175
Practice Address - Country:US
Practice Address - Phone:217-789-2069
Practice Address - Fax:217-535-3104
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.001105363L00000X
IL209-001105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner