SearchIllinois106E00000X

Jackson Loop

NPI 1912772146 · on the registry since 2023 · sole proprietor

Practice

Address
1215 Cleveland St
Evanston, IL 60202
Phone
(847) 257-5640

Registry record

Primary taxonomy
106E00000X
106E00000X
Sex
Male
Record last updated
2025-09-11

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