Kannan, Jacqueline L
Kannan, Jacqueline L is an sole proprietor health care provider with primary practice located at 4119 W Shamrock Ln , Mchenry IL 60050-8268. She recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as her primary health care specialty. Kannan, Jacqueline L can be contacted via phone (815) 398-9491.Contact Information
Primary practice address
4119 W Shamrock Ln
Mchenry IL 60050-8268
Phone: (815) 398-9491
Fax: (815) 381-7498
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 036-152551 | Illinois |
Profile Details
| NPI number | 1588058606 |
|---|---|
| LBN Legal business name | Kannan, Jacqueline L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 26th, 2015 |
| Last updated | Dec 21st, 2021 - about 4 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 | 1588058606 | NPPES |
| Illinois | MEDICAID | 125073073 |
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