IndividualActive
Agatha Jefferson, FNP
NPI 1083967624 · Nurse Practitioner · Northfield, IL
Provider details
- NPI number
- 1083967624
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- License
- 209009416 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1825 Willow Rd
Northfield, IL 60093-2925
Phone: (847) 825-4515
Fax: (847) 825-4515
Approximate (ZIP-level) locationGet directions
Mailing address
29373 Network Pl
Chicago, IL 60673-1293
Registry dates
- Enumerated
- 2012-10-19
- Last updated
- 2025-01-27
- Certified
- 2025-01-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.