Healthcare Provider Details

I. General information

NPI: 1235627712
Provider Name (Legal Business Name): JAZMINE T. RIOS APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAZMINE TAMANIO APRN, CNP

II. Dates (important events)

Enumeration Date: 04/30/2018
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE
EVANSTON IL
60201-1700
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2428
  • Fax:
Mailing address:
  • Phone: 847-570-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209017112
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209017112
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209017112
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: