Provider Demographics
NPI:1891320941
Name:SATHISH, JILL NICOLE (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:NICOLE
Last Name:SATHISH
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 E BELVIDERE RD STE 250
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2084
Mailing Address - Country:US
Mailing Address - Phone:847-535-7157
Mailing Address - Fax:847-535-7399
Practice Address - Street 1:1275 E BELVIDERE RD STE 250
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-2084
Practice Address - Country:US
Practice Address - Phone:847-535-7157
Practice Address - Fax:847-535-7399
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021516363LF0000X
IL209027809363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily