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General NPI Number Information
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NPI Number | 1568297752
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Entity Type | Individual
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Provider Name | JEZMINE MIZYED FNP
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Gender | Female
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Dates
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Enumeration Date | 09/05/2024
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Last Update Date | 02/21/2026
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Provider Practice Location Address
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Address Line | 875 N DEARBORN ST STE 300
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City | CHICAGO
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State | IL
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Zip | 60610-7377
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Country | US
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Telephone | 708-663-0611
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Fax |
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Provider Business Mailing Address
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Address Line | 633 W NORTH AVE APT 702
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City | CHICAGO
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State | IL
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Zip | 60610-0904
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Country | US
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Telephone | 708-663-0611
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95037956
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License Number State | CA
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