Individual
JACQUELINE DIANE NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
820 S DAMEN AVE RM 2535, CHICAGO, IL 60612
(312) 569-6376
(312) 569-8050
Mailing address
820 S DAMEN AVE RM 2535, CHICAGO, IL 60612-3728
(312) 569-6376
(312) 569-8050
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036-132962
IL
208100000X
Physical Medicine & Rehabilitation Physician
125055837
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036132962-1
—
IL
Enumeration date
08/27/2009
Last updated
06/23/2022
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