Healthcare Provider Details

I. General information

NPI: 1477954600
Provider Name (Legal Business Name): JESSICA MUI APRN-FPA, AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 W IRVING PARK RD
CHICAGO IL
60613-3077
US

IV. Provider business mailing address

3941 W DAKIN ST
CHICAGO IL
60618-3101
US

V. Phone/Fax

Practice location:
  • Phone: 773-525-6780
  • Fax:
Mailing address:
  • Phone: 312-469-0815
  • Fax: 312-680-8317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209011765
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number209011765
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: