Provider Demographics
NPI:1235603713
Name:ALAMILLO, JENNIFER M (APRN, FNP-C, FPA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:M
Last Name:ALAMILLO
Suffix:
Gender:F
Credentials:APRN, FNP-C, FPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 N LARKIN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-3441
Mailing Address - Country:US
Mailing Address - Phone:815-744-0029
Mailing Address - Fax:
Practice Address - Street 1:801 N LARKIN AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-3441
Practice Address - Country:US
Practice Address - Phone:815-744-0029
Practice Address - Fax:815-744-3768
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277003398363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty