Search › Illinois › 103TC0700X
Kenneth Jackson, PH.D
NPI 1588762108 · on the registry since 2006 · sole proprietor
Practice
- Address
- 5701 N Ashland Ave
Suite 205-A
Chicago, IL 60660 - Phone
- (773) 454-7202
- Fax
- (773) 465-5041
- Organisation at this address
- D Michael Kaye Md Pc
Bruce H. Hymanson, Md, PcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 103TC0700X
103TC0700X
- Also registered as
- 103TH0100X
- Licence states on file
- IL, IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2010-11-04
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