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NPI Code Detail

MEDICARE: MS. JENNIFER A. MISASI PNP-BC

MEDICARE: MS. JENNIFER A. MISASI PNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner209.005664IL

General Provider Information

NPI Number : 1184898660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER A. MISASI PNP-BC
Provider Business Mailing Address
First Line : 3319 N ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-2127
Country : US
Telephone Number : 773-747-8501
Fax Number :
Provider Business Practice Location Address
First Line : 3319 N ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-2127
Country : US
Telephone Number : 773-747-8501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2008
Last Update Date : 04/27/2026

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