Pongracic, Jacqueline Ann

Pongracic, Jacqueline Ann is an individual health care provider with primary practice located at 2515 N Clark St Childrens Memorial Hospital Outpatient Center, Chicago IL 60614. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology, which is considered as her primary health care specialty. Pongracic, Jacqueline Ann can be contacted via phone (312) 227-6010.

Contact Information

Primary practice address
2515 N Clark St Childrens Memorial Hospital Outpatient Center Chicago IL 60614
Phone: (312) 227-6010
Fax: (312) 227-9401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology 2080P0201X 036083010 Illinois

Profile Details

NPI number 1083674048
LBN Legal business name Pongracic, Jacqueline Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Sep 21st, 2011 - about 13 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 1083674048 NPPES
Illinois MEDICAID 036083010

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