Provider Demographics
NPI:1215828470
Name:GARCIA, JENNIFER REA (FNP-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:REA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LILISA
Other - Last Name:REA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3328 N DRAKE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-5472
Mailing Address - Country:US
Mailing Address - Phone:773-426-2214
Mailing Address - Fax:
Practice Address - Street 1:680 N LAKE SHORE DR STE 1028
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4451
Practice Address - Country:US
Practice Address - Phone:630-616-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.031840363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily