Healthcare Provider Details

I. General information

NPI: 1013390491
Provider Name (Legal Business Name): JULIA FIRLIT BUESSER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA ANNE FIRLIT MSN

II. Dates (important events)

Enumeration Date: 07/03/2015
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 S GREENLEAF ST STE J
GURNEE IL
60031-3377
US

IV. Provider business mailing address

3 S GREENLEAF ST STE J
GURNEE IL
60031-3377
US

V. Phone/Fax

Practice location:
  • Phone: 847-599-1111
  • Fax:
Mailing address:
  • Phone: 847-599-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209012894
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: