Individual
JESSICA RENEE PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
647 W LOSEY ST STE 3, GALESBURG, IL 61401-2594
(309) 351-7885
(309) 973-4121
Mailing address
647 W LOSEY ST STE 3, GALESBURG, IL 61401-2594
(309) 351-7885
(309) 973-4121
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85-2406035
IN HOME CARE SERVICES
IL
Enumeration date
08/17/2020
Last updated
08/17/2020
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