NPI 1053369546

Brian P Jacquot, PAC

Practitioner Physician Assistant Decatur, IL

Practice location

Address: 2300 N Edward St Suite 2350, Decatur, IL 62526-4163
Phone: (217) 876-2880
Fax: (217) 876-2885
Mailing address: 2300 N Edward St Gsbll, Decatur, IL 62526-4163

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 085001321 (IL)

Other Physician Assistant providers in Illinois →

Surgical Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence 10004104A (IN)

Registry record

NPI: 1053369546
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 May 2006
Record last updated: 10 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.