Search › Illinois › 343900000X
Ellen Jackson
NPI 1730353400 · on the registry since 2008 · sole proprietor
Practice
- Address
- 14122 S Wabash Ave
Riverdale, IL 60827 - Phone
- (708) 841-9473
- Fax
- (708) 880-0172
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2008-04-14
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