Healthcare Provider Details

I. General information

NPI: 1518322437
Provider Name (Legal Business Name): JESSICA ANN TORRE APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA HOMYAK CRNP

II. Dates (important events)

Enumeration Date: 12/18/2015
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 E ERIE ST STE 1450
CHICAGO IL
60611-3947
US

IV. Provider business mailing address

259 E ERIE ST STE 1450
CHICAGO IL
60611-3947
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-7746
  • Fax: 312-694-6387
Mailing address:
  • Phone: 312-695-7746
  • Fax: 312-694-6387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209013105
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP15363
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: