MEDICARE: MARYLU JOHN JOSEPH

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
1	363LF0000X	Family Nurse Practitioner	APN0000034991	TN

General Provider Information

NPI Number	:	1760250575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYLU JOHN JOSEPH

Provider Business Mailing Address
First Line	:	2701 PATRIOT BLVD
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-8039
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 PATRIOT BLVD
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-8039
Country	:	US
Telephone Number	:	847-475-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2023
Last Update Date	:	01/13/2026

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Directions to “ MARYLU JOHN JOSEPH ” Practice Location

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