Provider Demographics
NPI:1255752192
Name:FLECHET, KATHERINE JACKSON (APN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JACKSON
Last Name:FLECHET
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 REMINGTON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4707
Mailing Address - Country:US
Mailing Address - Phone:630-914-2898
Mailing Address - Fax:630-914-2469
Practice Address - Street 1:2222 W DIVISION ST STE 320
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3096
Practice Address - Country:US
Practice Address - Phone:312-770-3263
Practice Address - Fax:312-770-8663
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.011046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily