Leibforth, Jaclyn

Leibforth, Jaclyn is an sole proprietor health care provider with primary practice located at 2160 S 1St Ave , Maywood IL 60153-3328. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Leibforth, Jaclyn can be contacted via phone (888) 584-7888.

Contact Information

Primary practice address
2160 S 1St Ave Maywood IL 60153-3328
Phone: (888) 584-7888
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 209.028063 Illinois

Profile Details

NPI number 1356117253
LBN Legal business name Leibforth, Jaclyn
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2023
Last updated Nov 30th, 2023 - 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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