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Jessie Hansen
Specialist in Bolingbrook, Illinois
NPI 1992179972

Jessie Hansen is a Specialist based in Bolingbrook, IL. Jessie Hansen practices in Bolingbrook, IL. The NPI Number for Jessie Hansen is 1992179972 and holds a License No. 14D2099042 (Illinois).

The current practice location address for Jessie Hansen is 541 Spruce Rd, Bolingbrook, IL and can be reached out via phone at 630-880-6523 and via fax at 630-929-8057.

Location: 541 Spruce Rd, Bolingbrook, IL, 60440-2504
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992179972
Provider Name
Jessie Hansen
Credential
Provider Entity Type
Individual
Gender
Female
Address
541 Spruce Rd, Bolingbrook, IL, 60440-2504
Phone Number
630-880-6523
Fax Number
630-929-8057
Provider Enumeration Date
11/13/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
14D2099042 01 IL CERTIFICATE OF WAIVER CLIA
institution
Provider Business Practice Location Address Details
Address
541 Spruce Rd
City
Bolingbrook
State
Illinois
Zip
60440-2504
Phone Number
630-880-6523
Fax Number
630-929-8057
person
Provider Business Mailing Address Details
Address
541 Spruce Rd
City
Bolingbrook
State
Illinois
Zip
60440-2504
Phone Number
630-880-6523
Fax Number
630-929-8057
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
14D2099042 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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