Buck, Jacqueline N
Buck, Jacqueline N is an sole proprietor health care provider with primary practice located at 3200 Fishback Rd , Carbondale IL 62901-6307. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Buck, Jacqueline N can be contacted via phone (618) 457-1111.Contact Information
Primary practice address
3200 Fishback Rd
Carbondale IL 62901-6307
Phone: (618) 457-1111
Fax: (618) 351-1419
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 071.003131 | Illinois |
Profile Details
| NPI number | 1033383062 |
|---|---|
| LBN Legal business name | Buck, Jacqueline N |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 22nd, 2008 |
| Last updated | Apr 22nd, 2008 - about 16 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 | 1033383062 | NPPES |
| Illinois | Other | 071.003131 | STATE LICENSE |
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