Individual
DR. JACLYN KAY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO, MS
Contact information
Practice address
200 ABBOTT PARK RD, DEPT. R4NE, BLDG. AP34-2, ABBOTT PARK, IL 60064-6187
(847) 938-0133
Mailing address
200 ABBOTT PARK RD, DEPT. R4NE, BLDG. AP34-2, ABBOTT PARK, IL 60064-6187
(847) 938-0133
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
3715
IA
207RR0500X
Rheumatology Physician
Primary
036.125386
IL
207RR0500X
Rheumatology Physician
5874
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0727701
—
IA
01
—
26707
WELLMARK BCBS
IA
Enumeration date
06/27/2006
Last updated
10/01/2010
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