Vacarella, Jake S

Vacarella, Jake S is an individual health care provider with primary practice located at N2950 State Road 67 , Lake Geneva WI 53147-2655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Vacarella, Jake S can be contacted via phone (262) 245-0535.

Contact Information

Primary practice address
N2950 State Road 67 Lake Geneva WI 53147-2655
Phone: (262) 245-0535
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 36724 Wisconsin
Allopathic & Osteopathic Physicians / Pediatrics 208000000X Illinois

Profile Details

NPI number 1104986777
LBN Legal business name Vacarella, Jake S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Jul 8th, 2007 - about 17 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1104986777 NPPES
Wisconsin MEDICAID 32142800

Popular Providers