Jacksoneye Sc

NPI #1073669834 in Lake Villa, Illinois

Provider Information

NPI Number: 1073669834
Entity Type: Organization
Organization Name: Jacksoneye Sc
Primary Specialty: Ophthalmology
Enumeration Date: Jan 26, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 300 N MILWAUKEE AVE
Address 2: SUITE L
City: Lake Villa
State: Illinois
ZIP Code: 60046
Phone: (847) 356-0700

Authorized Official

Name: DR. MITCHELL ALIN JACKSON, MD
Title: CEO OWNER
Phone: (847) 356-0700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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