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Jeffrey Jackson
Student in an Organized Health Care Education/Training Program in Manteno, Illinois
NPI 1578193181

Jeffrey Jackson is a Student in an Organized Health Care Education/Training Program based in Manteno, IL. Jeffrey Jackson practices in Manteno, IL. The NPI Number for Jeffrey Jackson is 1578193181 and holds a License No. (Illinois).

The current practice location address for Jeffrey Jackson is 1055 W Longfellow Dr, Manteno, IL and can be reached out via phone at 815-549-2955. You can also correspond with Jeffrey Jackson through the mailing address at 1055 W LONGFELLOW DR, MANTENO, IL - 60950-9472 (mailing address contact number: ).

Location: 1055 W Longfellow Dr, Manteno, IL, 60950-9472
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578193181
Provider Name
Jeffrey Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
1055 W Longfellow Dr, Manteno, IL, 60950-9472
Phone Number
815-549-2955
Fax Number
Provider Enumeration Date
01/22/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1055 W Longfellow Dr
City
Manteno
State
Illinois
Zip
60950-9472
Phone Number
815-549-2955
Fax Number
person
Provider Business Mailing Address Details
Address
1055 W Longfellow Dr
City
Manteno
State
Illinois
Zip
60950-9472
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(Wisconsin)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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