Individual
LAUREN K JACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1893 SHERIDAN RD, #303, HIGHLAND PARK, IL 60035-2628
(847) 831-9304
(847) 831-9594
Mailing address
1893 SHERIDAN RD, #303, HIGHLAND PARK, IL 60035-2628
(847) 831-9304
(847) 831-9594
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036065604
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31601732
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/21/2005
Last updated
03/18/2015
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