Jackie Kay Hannon, DPT is a
Physical Medicine & Rehabilitation physician based in Waterloo, Illinois. Jackie Kay Hannon is licensed to practice in Illinois (license number 070.026314) and her current practice location is 706 Rogers St, Waterloo, Illinois. She can be reached at her office (for appointments etc.) via phone at
(618) 939-7761.
NPI number for Jackie Kay Hannon is 1558276402 and her current mailing address is 312 Quentin Ct, Waterloo, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1558276402.
Physician's Profile
| Full Name | Jackie Kay Hannon |
|---|
| Gender | Female |
|---|
| Speciality | Physical Medicine & Rehabilitation |
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| Location | 706 Rogers St, Waterloo, Illinois |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1558276402
- Provider Enumeration Date: 08/17/2026
- Last Update Date: 08/17/2026
Medical Identifiers
Medical identifiers for Jackie Kay Hannon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1558276402 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 208100000X | Physical Medicine & Rehabilitation | 070.026314 (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. Jackie Kay Hannon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Jackie Kay Hannon, DPT 312 Quentin Ct, Waterloo, IL 62298-1150 Ph: (618) 791-6735 | Jackie Kay Hannon, DPT 706 Rogers St, Waterloo, IL 62298-1780 Ph: (618) 939-7761 |
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