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NPI Code Detail

MEDICARE: JEREMY SOEDER APRN-FPA

MEDICARE: JEREMY SOEDER APRN-FPA
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
1363LA2100XAcute Care Nurse Practitioner277.004831IL
2363L00000XNurse Practitioner277.004831IL

General Provider Information

NPI Number : 1407312564
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY SOEDER APRN-FPA
Provider Business Mailing Address
First Line : 5645 W ADDISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60634-2881
Country : US
Telephone Number : 773-282-7000
Fax Number :
Provider Business Practice Location Address
First Line : 5645 W ADDISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60634-2881
Country : US
Telephone Number : 773-282-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2019
Last Update Date : 01/07/2026

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Directions to “ JEREMY SOEDER APRN-FPA” Practice Location

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