Provider Demographics
NPI:1013261361
Name:WINSKO, JENNA T (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:T
Last Name:WINSKO
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:MISS
Other - First Name:JENNA
Other - Middle Name:T
Other - Last Name:BUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:360 STATION DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7978
Mailing Address - Country:US
Mailing Address - Phone:815-477-8900
Mailing Address - Fax:815-477-7160
Practice Address - Street 1:360 STATION DR
Practice Address - Street 2:SUITE 120
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7978
Practice Address - Country:US
Practice Address - Phone:815-477-8900
Practice Address - Fax:815-477-7160
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009979363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health