Individual
JENNIFER M BELLUCCI JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
431 W LIBERTY ST, WAUCONDA, IL 60084-2452
(847) 526-2151
(847) 526-2017
Mailing address
PO BOX 6037, 431 W LIBERTY ST, WAUCONDA, IL 60084-6037
(847) 526-2151
(847) 526-2017
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036083207
IL
Other
Enumeration date
09/20/2005
Last updated
05/23/2023
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