Provider Demographics
NPI:1396488003
Name:SHAPIRO, JESSICA LYNNE (APRN, CNP)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LYNNE
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:WEINER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, CNP
Mailing Address - Street 1:676 N SAINT CLAIR ST STE 850
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3124
Mailing Address - Country:US
Mailing Address - Phone:312-695-6180
Mailing Address - Fax:312-695-6189
Practice Address - Street 1:676 N SAINT CLAIR ST STE 850
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3124
Practice Address - Country:US
Practice Address - Phone:312-695-6180
Practice Address - Fax:312-695-6189
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.434033163WX0200X
IL209025289363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WX0200XNursing Service ProvidersRegistered NurseOncology