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NPI Code Detail

MEDICARE: MRS. JOANNE MARIE ZIMMERLY FNP

MEDICARE: MRS. JOANNE MARIE ZIMMERLY FNP
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
1363LF0000XFamily Nurse Practitioner209003500IL

General Provider Information

NPI Number : 1811057094
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOANNE MARIE ZIMMERLY FNP
Provider Business Mailing Address
First Line : 2355 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-3837
Country : US
Telephone Number : 773-254-1400
Fax Number : 773-650-1218
Provider Business Practice Location Address
First Line : 2355 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-3837
Country : US
Telephone Number : 773-254-1400
Fax Number : 773-650-1218
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 06/25/2020

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