Search › Illinois › 222Q00000X
Jackie Anderson
NPI 1295004406 · on the registry since 2011 · sole proprietor
Practice
- Address
- 101 Shoreland Rd
Machesney Park, IL 61115 - Phone
- (815) 633-1173
Registry record
- Primary taxonomy
- 222Q00000X
222Q00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2011-12-16
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