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Damien Jackson
NPI 1588256424 · on the registry since 2021 · sole proprietor
Practice
- Address
- 201 Maplewood Ave
Mundelein, IL 60060 - Phone
- (773) 234-4808
- Organisation at this address
- Collaborative Counseling Group Of Illinois Pllc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-02-10
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