MEDICARE: MS. JINY M MOLLER APRN

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	209034695	IL

General Provider Information

NPI Number	:	1831055789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JINY M MOLLER APRN

Provider Business Mailing Address
First Line	:	3255 KIRCHOFF RD APT 203
Second Line	:
City	:	ROLLING MEADOWS
State	:	IL
Zip	:	60008-1870
Country	:	US
Telephone Number	:	708-996-2737
Fax Number	:

Provider Business Practice Location Address
First Line	:	3255 KIRCHOFF RD APT 203
Second Line	:
City	:	ROLLING MEADOWS
State	:	IL
Zip	:	60008-1870
Country	:	US
Telephone Number	:	708-996-2737
Fax Number	:

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

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	02/05/2026

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