Healthcare Provider Details

I. General information

NPI: 1588122568
Provider Name (Legal Business Name): MRS. JENNIFER SOLIS-ENGLISH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PHYSICIAN OFFICE CENTER, TOWER 2 3825 HIGHLAND AVENUE SUITE 306
DOWNERS GROVE IL
60515
US

IV. Provider business mailing address

2151 S FINLEY RD APT 704
LOMBARD IL
60148-6473
US

V. Phone/Fax

Practice location:
  • Phone: 630-929-0632
  • Fax:
Mailing address:
  • Phone: 617-953-2090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number209018924
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209018924
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: