Basic Information
Provider Information
NPI: 1770186652
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANCIS
FirstName: JHESTELIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3001 GREEN BAY RD
Address2:  
City: NORTH CHICAGO
State: IL
PostalCode: 600643048
CountryCode: US
TelephoneNumber: 8476881900
FaxNumber:  
Practice Location
Address1: 5645 W ADDISON ST
Address2:  
City: CHICAGO
State: IL
PostalCode: 606344403
CountryCode: US
TelephoneNumber: 7732827000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/20/2020
LastUpdateDate: 11/20/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/20/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X041350665ILN Nursing Service ProvidersRegistered Nurse 
163WC0200X041350665ILY Nursing Service ProvidersRegistered NurseCritical Care Medicine

No ID Information.


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