Provider Demographics
NPI:1386278687
Name:WRIGHT, JENNIFER L (APRN, CNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 N SAINT CLAIR ST STE 18-250
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5980
Mailing Address - Country:US
Mailing Address - Phone:312-695-5864
Mailing Address - Fax:312-926-4100
Practice Address - Street 1:675 N SAINT CLAIR ST STE 18-250
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5980
Practice Address - Country:US
Practice Address - Phone:312-695-5864
Practice Address - Fax:312-926-4100
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021961363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner