Active NPI
Jacqueline Tenor Girard, RN
- Critical Care Medicine Registered Nurse
- Pontiac, IL
National Provider Identifier
1972833416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 041-291130
- Practice address
- 2500 W Reynolds St
Pontiac, IL 61764-9774 - Phone
- (815) 842-4955
- NPI assigned
- Jan 6, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 041-291130 | IL | Primary |
Addresses
Primary practice location
2500 W Reynolds St
Pontiac, IL 61764-9774
Mailing address
303 N Walnut St
Wenona, IL 61377-7514
Phone (815) 853-0014
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041-291130 | IL | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262736000000",
"number": "1972833416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 N WALNUT ST",
"city": "WENONA",
"state": "IL",
"postal_code": "613777514",
"telephone_number": "815-853-0014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 W REYNOLDS ST",
"city": "PONTIAC",
"state": "IL",
"postal_code": "617649774",
"telephone_number": "815-842-4955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIRARD",
"first_name": "JACQUELINE",
"middle_name": "TENOR",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-06",
"last_updated": "2010-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "IL",
"license": "041-291130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.