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General NPI Number Information
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NPI Number | 1457606121
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Entity Type | Individual
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Provider Name | JENNIFER G DZEMSKE APNP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2012
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 5454 FARGO AVE
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City | SKOKIE
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State | IL
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Zip | 60077-3210
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Country | US
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Telephone | 847-221-6040
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Fax | 847-213-2156
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Provider Business Mailing Address
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Address Line | 5454 FARGO AVE
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City | SKOKIE
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State | IL
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Zip | 60077-3210
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Country | US
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Telephone | 847-221-6040
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Fax | 847-213-2156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 315608-31
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 13844
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License Number State | WI
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