Provider Demographics
NPI:1194063404
Name:FORBES, JESSICA LYNN (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:FORBES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 N OAKLEY BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-5908
Mailing Address - Country:US
Mailing Address - Phone:801-859-3933
Mailing Address - Fax:
Practice Address - Street 1:822 N OAKLEY BLVD APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-5908
Practice Address - Country:US
Practice Address - Phone:801-859-3933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209026692363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health