Healthcare Provider Details

I. General information

NPI: 1710382288
Provider Name (Legal Business Name): JESSICA T. CREMIEUX APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 PFINGSTEN RD. SUITE 330
GLENVIEW IL
60026-1300
US

IV. Provider business mailing address

800 BIESTERFIELD RD SUITE 510
ELK GROVE VILLAGE IL
60007-3361
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2450
  • Fax: 847-570-1865
Mailing address:
  • Phone: 847-981-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209011864
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209011864
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041363074
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: