Dr Jack A Cole, PHD is a medicare enrolled "Psychologist - Clinical" provider in Olney, Illinois. He graduated from medical school in 2004 and has 20 years of diverse experience with area of expertise as Clinical Psychologist. His current practice location is
302 S Kitchell Ave, Olney, Illinois. You can reach out to his office (for appointments etc.) via phone at
(618) 395-6261.
Dr Jack A Cole is licensed to practice in Illinois (license number ) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1619943784.
Healthcare Provider's Profile
| Full Name | Dr Jack A Cole |
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| Gender | Male |
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| Speciality | Clinical Psychologist |
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| Experience | 20 Years |
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| Location | 302 S Kitchell Ave, Olney, Illinois |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Jack A Cole graduated from medical school in 2004
NPI Data:
- NPI Number: 1619943784
- Provider Enumeration Date: 02/27/2006
- Last Update Date: 11/09/2007
Medicare PECOS Information:
- PECOS PAC ID: 7012937824
- Enrollment ID: I20110302000398
Medical Identifiers
Medical identifiers for Dr Jack A Cole such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619943784 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 20042023A (Indiana) | Secondary |
| 103TC0700X | Psychologist - Clinical | (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack A Cole is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jack A Cole, PHD
302 S. Kitchell Avenue,
Olney, IL 62450
Ph: (618) 395-6261 | Dr Jack A Cole, PHD
302 S Kitchell Ave,
Olney, IL 62450-1500
Ph: (618) 395-6261 |
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