Provider Demographics
NPI:1033433925
Name:VAN LOOVEREN, JESSICA EVA (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:EVA
Last Name:VAN LOOVEREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:EVA
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8136 OLD KEENE MILL RD STE B300
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1856
Mailing Address - Country:US
Mailing Address - Phone:703-451-6111
Mailing Address - Fax:703-451-6247
Practice Address - Street 1:8136 OLD KEENE MILL RD STE 300B300
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1850
Practice Address - Country:US
Practice Address - Phone:703-451-6111
Practice Address - Fax:703-451-6247
Is Sole Proprietor?:No
Enumeration Date:2010-03-21
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0079349207W00000X
VA0101255636207WX0009X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist