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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