Jaclyn L. Mis, PAC

Physician Assistant · Tinley Park, IL

Individual Active NPI

NPI number 1073899548

Practice location

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone
(815) 416-6641

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NPI record

NPI
1073899548
Entity type
Individual (Type 1)
Enumeration date
October 28, 2011
Last updated
July 24, 2023
Certified
July 24, 2023
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 085004190 IL

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone
(630) 469-9200
Fax
(708) 388-5672

Other practice locations (1)

  • 2320 High St, Blue Island, IL 60406-2426 · (708) 388-5500

About Jaclyn Mis

Jaclyn L. Mis, PAC is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 17495 La Grange Rd, Tinley Park, IL 60487-7581. The NPI number 1073899548 was assigned on October 28, 2011 and the record was last updated on July 24, 2023.

Jaclyn Mis lists a license in the registry: #085004190 (IL) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jaclyn L. Mis, PAC?

The NPI number is 1073899548.

What is the phone number of Jaclyn Mis?

The phone number listed for the practice location is (815) 416-6641.

Where is Jaclyn Mis located?

17495 La Grange Rd, Tinley Park, IL 60487-7581.

What is the taxonomy code for Jaclyn Mis?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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