Healthcare Provider Details

I. General information

NPI: 1780159996
Provider Name (Legal Business Name): JESSICA LYNN VOGT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 QUAIL RIDGE DR
WESTMONT IL
60559-6145
US

IV. Provider business mailing address

1431 IRIS AVE
CAROL STREAM IL
60188-3360
US

V. Phone/Fax

Practice location:
  • Phone: 630-986-2800
  • Fax:
Mailing address:
  • Phone: 708-214-8441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277.002230
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: