Healthcare Provider Details

I. General information

NPI: 1770186652
Provider Name (Legal Business Name): JHESTELIN FRANCIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2020
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 W ADDISON ST
CHICAGO IL
60634-4403
US

IV. Provider business mailing address

3001 GREEN BAY RD
NORTH CHICAGO IL
60064-3048
US

V. Phone/Fax

Practice location:
  • Phone: 773-282-7000
  • Fax:
Mailing address:
  • Phone: 847-688-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041350665
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number041350665
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: