Enter, Jack C.

Enter, Jack C. is an individual health care provider with primary practice located at 4211 N Cicero Ave Suite 100, Chicago IL 60641-1651. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Enter, Jack C. can be contacted via phone (773) 794-1000.

Contact Information

Primary practice address
4211 N Cicero Ave Suite 100 Chicago IL 60641-1651
Phone: (773) 794-1000
Fax: (773) 794-9986
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085-000925 Illinois

Profile Details

NPI number 1366444184
LBN Legal business name Enter, Jack C.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Oct 17th, 2008 - about 18 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 1366444184 NPPES
Illinois Other 085.000925 LICENSE

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