Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 209-001911 | IL |
NPI | 1033148796 |
---|---|
Provider Name | Ms. Jennifer Mary Duff |
First Address | Chicago, IL 60625 |
Second Address | Chicago, IL 60612-3723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 07/03/2013 |