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Contact Information

JESSICA M WACHTEL, PA
509 HAMACHER STREET
SUITE 102
WATERLOO, IL62298
 Phone: 618-939-3939
 Fax: 618-939-3941
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JESSICA M WACHTEL · (Female)

NPI # 1306829775
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 11/21/2005
Last updated 05/09/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 085002375
  • Other 546390 MEDICARE-ID-UNSPEC.
Hospital affiliation(s)
  • GATEWAY REGIONAL MEDICAL CENTER - (Acute Care)
    2100 MADISON AVENUE
    GRANITE CITY, IL 62040
  • RED BUD REGIONAL HOSPITAL - (Critical Access)
    325 SPRING STREET
    RED BUD, IL 62278
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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