Most Relevant Information
Provider Data
| NPI Number: | 1003815770 |
| Provider Name: | SANDRA JAESCHKE CNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209003766 |
Most Important Dates
| Enumeration Date: | 07/15/2005 |
| Last Updated: | 08/08/2017 |
Provider Practice Location
360 STATION DR
CRYSTAL LAKE
IL
600147978
Practice Location Phone/Fax
| Phone: | 8153386600 |
| Fax: | 8154558044 |
Provider Mailing Location
360 STATION DR
CRYSTAL LAKE
IL
60014
Provider Mailing Phone/Fax
| Phone: | 8153386600 |
| Fax: |