Rognstad, Jacquelyn Joyce

Rognstad, Jacquelyn Joyce is an sole proprietor health care provider with primary practice located at 81 E Grand Ave , Fox Lake IL 60020-1557. She recently has 4 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Methadone, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder, Nursing Service Providers / Registered Nurse. Nursing Service Providers / Registered Nurse is her primary health care specialty. Rognstad, Jacquelyn Joyce can be contacted via phone (224) 908-3005.

Contact Information

Primary practice address
81 E Grand Ave Fox Lake IL 60020-1557
Phone: (224) 908-3005
Fax: (815) 814-8989
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Methadone 261QM2800X
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X
Nursing Service Providers / Registered Nurse 163W00000X 041.395865 Illinois

Profile Details

NPI number 1770018780
LBN Legal business name Rognstad, Jacquelyn Joyce
Credentials BSN, RN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 27th, 2017
Last updated Nov 29th, 2017 - about 9 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 1770018780 NPPES
Illinois MEDICAID 1770018780

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