Healthcare Provider Details

I. General information

NPI: 1851864839
Provider Name (Legal Business Name): JOYCE DESPE APRN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2019
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 RANDALL RD
GENEVA IL
60134-4200
US

IV. Provider business mailing address

304 RANDALL RD
GENEVA IL
60134-4200
US

V. Phone/Fax

Practice location:
  • Phone: 630-232-0610
  • Fax: 630-232-0675
Mailing address:
  • Phone: 630-232-0610
  • Fax: 630-232-0675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number209018167
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number209018167
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: