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NPI Code Detail

MEDICARE: JESSE SCALA

MEDICARE:   JESSE  SCALA
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
1163W00000XRegistered Nurse041479678IL

General Provider Information

NPI Number : 1730043134
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE SCALA
Provider Business Mailing Address
First Line : 2311 N KIMBALL AVE APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2431
Country : US
Telephone Number : 773-803-0000
Fax Number :
Provider Business Practice Location Address
First Line : 2311 N KIMBALL AVE APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2431
Country : US
Telephone Number : 773-803-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2025
Last Update Date : 12/11/2025

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Directions to “ JESSE SCALA ” Practice Location

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