Individual
JAMIE J OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
109 E MAPLE ST, GILLESPIE, IL 62033-1473
(217) 854-3223
Mailing address
205 OAKLAND AVE, CARLINVILLE, IL 62626-1921
(217) 854-3223
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209003494
IL
363LF0000X
Family Nurse Practitioner
209003494
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006015346
BLUE CROSS BLUE SHIELD OF
IL
01
—
500012843
RAILROAD MEDICARE
—
Enumeration date
06/06/2006
Last updated
03/02/2026
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