Search › Illinois › 390200000X
Jeffrey Jackson
NPI 1578193181 · on the registry since 2020
Practice
- Address
- 1055 W Longfellow Dr
Manteno, IL 60950 - Phone
- (815) 549-2955
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-01-22
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