Provider Demographics
NPI:1003454943
Name:TOLENTINO, JOELLE MARIE (APRN, CNP)
Entity type:Individual
Prefix:
First Name:JOELLE
Middle Name:MARIE
Last Name:TOLENTINO
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 1:1438 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-8977
Mailing Address - Country:US
Mailing Address - Phone:630-235-6203
Mailing Address - Fax:
Practice Address - Street 1:351 DELNOR DR STE 401
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4235
Practice Address - Country:US
Practice Address - Phone:630-933-4056
Practice Address - Fax:630-933-4056
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041326362363LF0000X, 163W00000X
IL209020953363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse