Provider Demographics
NPI:1346810488
Name:ZUPANSIC, JILL COLLEEN (APN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:COLLEEN
Last Name:ZUPANSIC
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3909 CEDAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60051-6367
Mailing Address - Country:US
Mailing Address - Phone:847-561-0997
Mailing Address - Fax:
Practice Address - Street 1:500 PARK AVE STE 104
Practice Address - Street 2:
Practice Address - City:LAKE VILLA
Practice Address - State:IL
Practice Address - Zip Code:60046-6550
Practice Address - Country:US
Practice Address - Phone:847-245-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209023470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily