Healthcare Provider Details

I. General information

NPI: 1427532746
Provider Name (Legal Business Name): JENNIFER D RECKER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 07/13/2025
Certification Date: 07/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 N MICHIGAN AVE STE 1090
CHICAGO IL
60611-4521
US

IV. Provider business mailing address

1014 N MEADOW LN
MOUNT PROSPECT IL
60056-1125
US

V. Phone/Fax

Practice location:
  • Phone: 847-302-9916
  • Fax: 855-596-4318
Mailing address:
  • Phone: 847-338-0057
  • Fax: 855-596-4318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209020702
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0994112
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95010948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: