Jackie Kay Hannon, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

070.026314 Issued in IL

Practice address

706 Rogers St
Waterloo, IL 62298-1780

Phone

(618) 939-7761

NPI assigned

Aug 17, 2026

Last updated

Aug 17, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • Speech-Language Pathologist
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  • NPI 1649022518
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1786924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1558276402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 QUENTIN CT",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981150",
            "telephone_number": "618-791-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 ROGERS ST",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981780",
            "telephone_number": "618-939-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNON",
        "first_name": "JACKIE",
        "middle_name": "KAY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-17",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "070.026314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Lee Haberl
• Lisa Halbrooks, MHP
• Amanda Haley, RSA
• Ashely Hall, RSA
• Shyrl Hamilton, MHP
• Kristen Harris, MHP
• Melissa I. Harris, LCPC, LMHC
• Brooke Hartmann, RSA
• Darryn Haudrich, LPC
• Kenneth D Hawn, MD

• Physical Medicine & Rehabilitation Physician in Waterloo, IL
• Providers in Waterloo, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.