Ida Jackson, LCPC,

NPI 1659682037 · on the registry since 2010

Practice

Address: 4314 S Cottage Grove Ave
Suite 208
Chicago, IL 60653
Phone: (312) 747-0036
Fax: (312) 747-2208
Organisation at this address: Chicago Department Of Public Health
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 7

Registry record

Primary taxonomy: 101YM0800X
101YM0800X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2010-06-30

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