Jessica Dominique Taylor | Homewood, IL • PECOS Search

Jessica Dominique Taylor

Chiropractor

Chiropractic Providers

2417 183rd St, Homewood, IL 60430-3134

(708) 798-5556 1708574926

PECOS Enrollment

Based on the most recent information from CMS, provider Jessica Dominique Taylor does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1962000125
Provider Type
Individual
Full Name
Taylor, Jessica Dominique
Credential
DC

Gender
Female
Sole Proprietor
No
Enumeration Date
10/10/2020
Last Updated
10/10/2020

Contact Information

Practice Location

2417 183rd St, Homewood, IL 60430-3134

Unlisted Fax

Mailing Location

1821 Quail Ct, Flossmoor, IL 60422-2048

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 111N00000X Primary	Description Chiropractor Chiropractic Providers	License 038.013609 Illinois