Hall, Jack J

Hall, Jack J is an individual health care provider with primary practice located at 619 E Mason St Ste 4P57 , Springfield IL 62701. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Hall, Jack J can be contacted via phone (217) 788-0706.

Contact Information

Primary practice address
619 E Mason St Ste 4P57 Springfield IL 62701
Phone: (217) 788-0706
Fax: (217) 525-2535
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 01038562A Indiana
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 01038562A Indiana
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 129026 Montana
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 036136720 Illinois

Profile Details

NPI number 1558337857
LBN Legal business name Hall, Jack J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Sep 7th, 2023 - about last year

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 1558337857 NPPES
Indiana MEDICAID 200063500
Indiana Other P01427268

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