Healthcare Provider Details

I. General information

NPI: 1538021878
Provider Name (Legal Business Name): JENNIFER R OBAZEE PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2735 HASSERT BLVD STE 135
NAPERVILLE IL
60564-5205
US

IV. Provider business mailing address

2735 HASSERT BLVD STE 135
NAPERVILLE IL
60564-5205
US

V. Phone/Fax

Practice location:
  • Phone: 331-253-8605
  • Fax:
Mailing address:
  • Phone: 331-253-8605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209034069
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: