Jacquelyn Cooper, is a
Licensed Practical Nurse based in Hillside, Illinois. Jacquelyn Cooper is licensed to practice in Illinois (license number 043081911) and her current practice location is
230 N Lind Ave, Hillside, Illinois. She can be reached at her office (for appointments etc.) via phone at
(773) 587-0827.
NPI number for Jacquelyn Cooper is 1124667621 and her current mailing address is 230 N Lind Ave, Hillside, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1124667621.
Provider's Profile
Full Name | Jacquelyn Cooper |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 230 N Lind Ave, Hillside, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1124667621
- Provider Enumeration Date: 12/31/2019
- Last Update Date: 12/31/2019
Medical Identifiers
Medical identifiers for Jacquelyn Cooper such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124667621 | NPI | - | NPPES |
043081911 | Medicaid | IL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 043081911 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacquelyn Cooper is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jacquelyn Cooper, 230 N Lind Ave, Hillside, IL 60162-1538 Ph: (773) 587-0827 | Jacquelyn Cooper, 230 N Lind Ave, Hillside, IL 60162-1538 Ph: (773) 587-0827 |
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