JACLYN JOY HAKE PA-C - NPI 1497994727 - Physician Assistant in Gillespie, IL

Q: What is Jaclyn Hake's NPI number?

The NPI number for Jaclyn Hake is 1497994727. It was assigned to this individual provider in the NPPES registry on February 10, 2009.

Q: What is Jaclyn Hake's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Jaclyn Hake was last updated on April 11, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Jaclyn Joy Hake Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACLYN JOY HAKE PA-C (NPI 1497994727) is an individual medical provider in Gillespie, Illinois, licensed in Illinois (085003429) and active in the NPI registry since February 2009.

NPPES Registry Identity

NPI1497994727

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameJACLYN JOY HAKECredential: PA-C

Location Address715 BROADWAY STGillespie, IL 62033-1166

Mailing Address715 Broadway StGillespie, IL 62033-1166 · (217) 839-2689 · Fax (217) 839-2689

Phone(217) 839-2689

Fax(217) 839-2689

Sole ProprietorNo

Enumeration DateFebruary 10, 2009

Last NPPES UpdateApril 11, 2014

✔ NPI 1497994727 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in IL · 085003429

715 BROADWAY ST, Gillespie, IL 62033

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Other Identifiers 1

Other085003429IL · Il License

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MACOUPIN FAMILY PRACTICE CENTER, LLP

Family Medicine