MEDICARE: COLLEGE OF NURSING FACULTY PRACTICE

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	261QS1000X	Student Health Clinic/Center

General Provider Information

NPI Number	:	1619633278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLEGE OF NURSING FACULTY PRACTICE

Provider Business Mailing Address
First Line	:	300 S ASHLAND AVE STE 101E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-3856
Country	:	US
Telephone Number	:	312-942-2364
Fax Number	:

Provider Business Practice Location Address
First Line	:	244 E PERSHING RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60653-2222
Country	:	US
Telephone Number	:	312-942-2364
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SALLY LEMKE
Credential	:
Telephone Number	:	312-563-6830

Provider Enumeration Date	:	11/09/2021
Last Update Date	:	03/13/2026

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