Individual provider · Type 1 NPI
Cynthia Ann Jack, NP
Nurse Practitioner · Rockford, IL
Practice location
2300 N Rockton Ave
Rockford, IL 61103-3619
Other practice locations
- 2000 Lake Ave, Woodstock, IL 60098-7401 · (815) 337-7100
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Occupational Health Nurse Practitioner | 363LX0106X | 209009900 (IL) |
| Nurse Practitioner Primary | 363L00000X | 209.009900 (IL) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1710222807
Cynthia Ann Jack, NP's National Provider Identifier is 1710222807, issued on Nov 30, 2012. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Rockford, IL. The record was last updated on Sep 29, 2026.