Jessen, Jon Niles
Jessen, Jon Niles is an sole proprietor health care provider with primary practice located at 701 N 1St St , Springfield IL 62781-0001. He recently has 2 registered licenses in different health care specialties including Emergency Medical Service Providers / Personal Emergency Response Attendant, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Jessen, Jon Niles can be contacted via phone (217) 522-3122.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Emergency Medical Service Providers / Personal Emergency Response Attendant | 146D00000X | 036071861 | Illinois |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 036071861 | Illinois |
Profile Details
| NPI number | 1912970823 |
|---|---|
| LBN Legal business name | Jessen, Jon Niles |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 10th, 2006 |
| Last updated | Apr 29th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912970823 | NPPES |
| Illinois | MEDICAID | 0360718611 |
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