Individual ProviderJenice LopezNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address77 Rand Rd, Des Plaines, IL 60016-1005(847) 296-3040(847) 390-5900PECOS EnrollmentBased on the most recent information from CMS, provider Jenice Lopez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1205440948Provider TypeIndividualFull NameLopez, JeniceCredentialFNP-CGenderFemaleSole ProprietorNoEnumeration Date9/1/2020Last Updated10/16/2023Contact InformationPractice LocationPractice Address77 Rand Rd, Des Plaines, IL 60016-1005Phone(847) 296-3040FaxUnlisted FaxMailing LocationMailing Address29373 Network Pl, Chicago, IL 60673-1293Phone(847) 390-5900FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense209021901IllinoisCode363L00000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense209-021901Illinois