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NPI Code Detail

MEDICARE: JESSICA MARIE KINCAID

MEDICARE: JESSICA MARIE KINCAID
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner209034636IL
2163W00000XRegistered Nurse041428433IL

General Provider Information

NPI Number : 1386447829
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MARIE KINCAID
Provider Business Mailing Address
First Line : 3815 HIGHLAND AVE UNIT 33
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-1590
Country : US
Telephone Number : 773-318-9259
Fax Number :
Provider Business Practice Location Address
First Line : 333 MADISON ST
Second Line :
City : JOLIET
State : IL
Zip : 60435-8200
Country : US
Telephone Number : 815-725-7133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2025
Last Update Date : 04/22/2026

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