Individual provider · Type 1 NPI

Jessica Amini Panah

Nurse Practitioner · Lisle, IL

NPI number 1720760705 Active

Practice location

430 Warrenville Rd
Lisle, IL 60532-1348

Fax (630) 432-6604

Mailing address

Pob 7132960
Chicago, IL 60677-1260

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner 363LA2200X209.032196 (IL)
Nurse Practitioner Primary 363L00000X209-032196 (IL)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1720760705

Jessica Amini Panah's National Provider Identifier is 1720760705, issued on Aug 1, 2023. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Lisle, IL. The record was last updated on Jun 26, 2026.