MEDICARE: JAZMINE T. RIOS APRN, CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209017112	IL
2	363L00000X	Nurse Practitioner	209017112	IL
3	363LA2100X	Acute Care Nurse Practitioner	209017112	IL

General Provider Information

NPI Number	:	1235627712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAZMINE T. RIOS APRN, CNP

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE STE 1223
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-570-2040
Fax Number	:

Provider Business Practice Location Address
First Line	:	2650 RIDGE AVE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-570-2428
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2018
Last Update Date	:	04/21/2026

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