Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 209006186 | IL |
NPI | 1013061316 |
---|---|
Provider Name | Jennifer M. Leskis |
First Address | Hoffman Estates, IL 60192-3727 |
Second Address | Hoffman Estates, IL 60192-3727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 02/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00617713 | MEDICARE RAILROAD (01) | IL |