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NPI Code Detail

MEDICARE: JOYOUS SUBADE FNP-C

MEDICARE: JOYOUS SUBADE FNP-C
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
1363LF0000XFamily Nurse Practitioner209.024947IL

General Provider Information

NPI Number : 1497404685
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOYOUS SUBADE FNP-C
Provider Business Mailing Address
First Line : 1131 COVE DR
Second Line :
City : PROSPECT HEIGHTS
State : IL
Zip : 60070-1904
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4101 LAKE COOK RD
Second Line :
City : NORTHBROOK
State : IL
Zip : 60062-1112
Country : US
Telephone Number : 847-562-1770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2022
Last Update Date : 05/16/2022

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