Jessen, Jon Niles

Jessen, Jon Niles is an sole proprietor health care provider with primary practice located at 701 N 1St St , Springfield IL 62781-0001. He recently has 2 registered licenses in different health care specialties including Emergency Medical Service Providers / Personal Emergency Response Attendant, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Jessen, Jon Niles can be contacted via phone (217) 522-3122.

Contact Information

Primary practice address
701 N 1St St Springfield IL 62781-0001
Phone: (217) 522-3122
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Personal Emergency Response Attendant 146D00000X 036071861 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036071861 Illinois

Profile Details

NPI number 1912970823
LBN Legal business name Jessen, Jon Niles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 10th, 2006
Last updated Apr 29th, 2024 - about 8 months 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 1912970823 NPPES
Illinois MEDICAID 0360718611

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