Madunic, Jacqueline A

Madunic, Jacqueline A is an individual health care provider with primary practice located at 2545 24Th St , Rock Island IL 61201-5305. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Madunic, Jacqueline A can be contacted via phone (309) 788-0458.

Contact Information

Primary practice address
2545 24Th St Rock Island IL 61201-5305
Phone: (309) 788-0458
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.006129 Illinois

Profile Details

NPI number 1659889913
LBN Legal business name Madunic, Jacqueline A
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2018
Last updated Aug 6th, 2021 - about 5 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 1659889913 NPPES
Iowa Other 089569 LICENSE
Iowa Other 149.006129 LICENSE

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