Credille, Jamieson T
Credille, Jamieson T is an sole proprietor health care provider with primary practice located at 1513 Dekalb Ave , Sycamore IL 60178-2703. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, which is considered as her primary health care specialty. Credille, Jamieson T can be contacted via phone (815) 758-0000.Contact Information
Primary practice address
1513 Dekalb Ave
Sycamore IL 60178-2703
Phone: (815) 758-0000
Fax: (815) 991-9484
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic | 2251X0800X |
Profile Details
| NPI number | 1467978882 |
|---|---|
| LBN Legal business name | Credille, Jamieson T |
| Credentials | DPT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2017 |
| Last updated | Aug 17th, 2017 - about 8 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 | 1467978882 | NPPES |
| Illinois | Other | 070023046 | PHYSICAL THERAPIST LICENSE |
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