Sandra Jaeschke
Nurse Practitioner
360 Station Dr
Crystal Lake
, Illinois 60014-7978
Sandra Jaeschke
Nurse Practitioner
360 Station Dr
Crystal Lake
, Illinois 60014-7978
(815) 338-6600
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About
Features
Specialties
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Sandra Jaeschke
- 360 Station Dr
- Crystal Lake, IL
- Zip : 60014
- Phone : (815) 338-6600
Second Address
- Sandra Jaeschke
- 360 Station Dr
- Crystal Lake, IL
- Zip : 60014-7978
- Fax : (815) 455-8044
- Phone : (815) 338-6600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209003766 | IL |
National Provider Identifier
| NPI | 1003815770 |
|---|---|
| Provider Name | Sandra Jaeschke |
| First Address | Crystal Lake, IL 60014 |
| Second Address | Crystal Lake, IL 60014-7978 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/07/2005 |
| Last Update Date | 08/08/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| P44554 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.