Provider Demographics
NPI:1558664052
Name:JAJKO, NIKKA C (APN)
Entity Type:Individual
Prefix:
First Name:NIKKA
Middle Name:C
Last Name:JAJKO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 E. ERIE
Mailing Address - Street 2:13TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-472-6052
Mailing Address - Fax:
Practice Address - Street 1:259 E. ERIE
Practice Address - Street 2:13TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-472-6052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008099363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36090804Medicaid
IL377780OtherMEDICARE IL-TYPE
L81161OtherMEDICARE ID-TYPE UNSPECIFIED
ILG17617Medicare UPIN