Kim, Jessica Stephanie

Kim, Jessica Stephanie is an individual health care provider with primary practice located at 5656 S Maryland Ave , Chicago IL 60637. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Emergency, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Kim, Jessica Stephanie can be contacted via phone (773) 702-1220.

Contact Information

Primary practice address
5656 S Maryland Ave Chicago IL 60637
Phone: (773) 702-1220
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Emergency 163WE0003X 041399309 Illinois
Nursing Service Providers / Emergency 163WE0003X 95236442 California
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 95016336 California
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 209.021840 Illinois

Profile Details

NPI number 1225656432
LBN Legal business name Kim, Jessica Stephanie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2020
Last updated Aug 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225656432 NPPES
Illinois Other 209.021840 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

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