Search › Illinois › 363A00000X
Jacylyn Wahl, MPAS, PA-C
NPI 1245715309 · on the registry since 2018
Practice
- Address
- 150 E Cook Ave Ste 100
Libertyville, IL 60048 - Phone
- (847) 232-3342
- Organisation at this address
- Ryan T Porter
Nutrition-Preneur LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 9
Additional practice sites
- 1650 Cochrane Cir, Fort Carson, CO
- 12970 W Bluemound Rd Ste 200, Elm Grove, WI
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-01-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois