Healthcare Provider Details

I. General information

NPI: 1003454943
Provider Name (Legal Business Name): JOELLE MARIE TOLENTINO APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 DELNOR DR STE 401
GENEVA IL
60134-4235
US

IV. Provider business mailing address

1438 PATTERSON AVE
NORTH AURORA IL
60542-8977
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-4056
  • Fax: 630-933-4056
Mailing address:
  • Phone: 630-235-6203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number041326362
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209020953
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041326362
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: