Anderson, Jaclyn Kay

Anderson, Jaclyn Kay is an individual health care provider with primary practice located at 200 Abbott Park Rd Dept. R4Ne, Bldg. Ap34-2, Abbott Park IL 60064-6187. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Rheumatology is her primary health care specialty. Anderson, Jaclyn Kay can be contacted via phone (847) 938-0133.

Contact Information

Primary practice address
200 Abbott Park Rd Dept. R4Ne, Bldg. Ap34-2 Abbott Park IL 60064-6187
Phone: (847) 938-0133
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 3715 Iowa
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 5874 Nebraska
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 036.125386 Illinois

Profile Details

NPI number 1316974041
LBN Legal business name Anderson, Jaclyn Kay
Credentials DO, MS
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Oct 1st, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316974041 NPPES
Iowa Other 26707 WELLMARK BCBS
Iowa MEDICAID 0727701 WELLMARK BCBS

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