SearchIllinois225700000X

Bryanna Jackson

NPI 1982388104 · on the registry since 2023 · sole proprietor

Practice

Address
638 W 103rd St
Chicago, IL 60628
Phone
(773) 587-7614

Registry record

Primary taxonomy
225700000X
225700000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-06-09

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