Provider Demographics
NPI:1447697032
Name:KRAUSE, JESSICA SUE (NNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:SUE
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:SUE
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8004 CLARENDON HILLS RD
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-2432
Mailing Address - Country:US
Mailing Address - Phone:630-664-0581
Mailing Address - Fax:
Practice Address - Street 1:1750 W HARRISON ST FL 6
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3825
Practice Address - Country:US
Practice Address - Phone:312-942-5068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-010437363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal