Healthcare Provider Details

I. General information

NPI: 1447761002
Provider Name (Legal Business Name): JAMEESE YNEZ SYKES APN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2017
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 S HALSTED ST
CHICAGO IL
60621
US

IV. Provider business mailing address

4009 N BROADWAY ST
CHICAGO IL
60613-2110
US

V. Phone/Fax

Practice location:
  • Phone: 773-275-2586
  • Fax:
Mailing address:
  • Phone: 773-275-2586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209016753
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.016753
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: