Pacaccio, Jennifer Jo

Pacaccio, Jennifer Jo is an individual health care provider with primary practice located at 2180 Oakland Dr Unit A, Sycamore IL 60178-3122. She recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is her primary health care specialty. Pacaccio, Jennifer Jo can be contacted via phone (815) 669-4811.

Contact Information

Primary practice address
2180 Oakland Dr Unit A Sycamore IL 60178-3122
Phone: (815) 669-4811
Fax: (815) 986-6062
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016.005347 Illinois
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 0103300964 Virginia

Profile Details

NPI number 1013113265
LBN Legal business name Pacaccio, Jennifer Jo
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2007
Last updated May 8th, 2015 - about 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1013113265 NPPES
Illinois MEDICAID 016005347

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