Gancayco, Jamie

Gancayco, Jamie is an individual health care provider with primary practice located at 781 S Mchenry Ave , Crystal Lake IL 60014-7444. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Gancayco, Jamie can be contacted via phone (815) 459-2200.

Contact Information

Primary practice address
781 S Mchenry Ave Crystal Lake IL 60014-7444
Phone: (815) 459-2200
Fax: (815) 788-9263
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036101835 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036101835 Illinois

Profile Details

NPI number 1669470431
LBN Legal business name Gancayco, Jamie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Dec 29th, 2021 - about 3 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 1669470431 NPPES
Illinois Other 215184001 MEDICARE PTAN
Illinois Other 962341 MEDICARE PTAN
Illinois MEDICAID 036101835 MEDICARE PTAN
Illinois Other 04532206 MEDICARE PTAN

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