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General NPI Number Information
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NPI Number | 1932517372
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Entity Type | Individual
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Provider Name | JAMIE WOURMS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/29/2014
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Last Update Date | 11/29/2016
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Provider Practice Location Address
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Address Line | ADVOCATE MEDICAL GROUP - ADVOCATE CLINIC DOWNERS GROVE 1000 OGDEN AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2803
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Country | US
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Telephone | 224-225-0244
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Fax | 224-225-0367
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Provider Business Mailing Address
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Address Line | ADVOCATE MEDICAL GROUP - ADVOCATE CLINIC DOWNERS GROVE 1000 OGDEN AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2803
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Country | US
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Telephone | 224-225-0244
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Fax | 224-225-0367
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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 | 209011669
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License Number State | IL
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