Jeffrey Jackson

NPI #1578193181 in Manteno, Illinois

Provider Information

NPI Number: 1578193181
Entity Type: Individual
Name: Jeffrey Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jan 22, 2020
Last Updated: Jan 22, 2020

Practice Location

Address: 1055 W LONGFELLOW DR
City: Manteno
State: Illinois
ZIP Code: 60950-9472
Phone: (815) 549-2955

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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