Provider Demographics
NPI:1962434563
Name:KRESS, JUDITH ANN (FNP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:KRESS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:ANN
Other - Last Name:WINSLOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:1370 S WHITE OAK DR
Mailing Address - Street 2:#117
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-8366
Mailing Address - Country:US
Mailing Address - Phone:623-693-6734
Mailing Address - Fax:
Practice Address - Street 1:1370 S WHITE OAK DR
Practice Address - Street 2:#117
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-8366
Practice Address - Country:US
Practice Address - Phone:623-693-6734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041180230363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ118192Medicare PIN