Healthcare Provider Details

I. General information

NPI: 1134939473
Provider Name (Legal Business Name): JESSICA POGGI HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3077 W JEFFERSON ST STE 206
JOLIET IL
60435-5264
US

IV. Provider business mailing address

3077 W JEFFERSON ST STE 206
JOLIET IL
60435-5264
US

V. Phone/Fax

Practice location:
  • Phone: 815-744-1214
  • Fax: 815-725-6507
Mailing address:
  • Phone: 815-744-1214
  • Fax: 815-725-6507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3581
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: