Search › Illinois › 104100000X
Jasmine Mack
NPI 1114842408 · on the registry since 2026 · sole proprietor
Practice
- Address
- 5628 S Prairie Ave
Chicago, IL 60637 - Phone
- (773) 491-6476
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Also registered as
- 101YM0800X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-08-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois