Mis, Jaclyn L

Mis, Jaclyn L is an individual health care provider with primary practice located at 17495 La Grange Rd , Tinley Park IL 60487-7581. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mis, Jaclyn L can be contacted via phone (815) 416-6641.

Contact Information

Primary practice address
17495 La Grange Rd Tinley Park IL 60487-7581
Phone: (815) 416-6641
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085004190 Illinois

Profile Details

NPI number 1073899548
LBN Legal business name Mis, Jaclyn L
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2011
Last updated Jul 24th, 2023 - about 2 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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