Provider Demographics
NPI:1194972828
Name:JAMES, JUDITH WHITFORD (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:WHITFORD
Last Name:JAMES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6131 DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2953
Mailing Address - Country:US
Mailing Address - Phone:847-967-5010
Mailing Address - Fax:847-967-5147
Practice Address - Street 1:6131 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2953
Practice Address - Country:US
Practice Address - Phone:847-967-5010
Practice Address - Fax:847-967-5147
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.007201363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209.007201OtherADV. PRACTICE NURSE-CERTIFIED NURSE PRACTITINER