Healthcare Provider Details

I. General information

NPI: 1134031651
Provider Name (Legal Business Name): TAYLOR-SIMONE JENNINGS MSN,RN, C-EFM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6825 FORESTVIEW DR APT 3A
OAK FOREST IL
60452-1632
US

IV. Provider business mailing address

6825 FORESTVIEW DR APT 3A
OAK FOREST IL
60452-1632
US

V. Phone/Fax

Practice location:
  • Phone: 773-879-0993
  • Fax:
Mailing address:
  • Phone: 773-879-0993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number041508396
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: