Dr. Juanita Jackson, PharmD
Pharmacist in Chicago, IL. Individual provider (NPI-1).
NPI number1245033604
StatusActive
Last updated in NPPESMar 31, 2025
Details
- NPI
- 1245033604
- Entity type
- Individual (NPI-1)
- Name
- Dr. Juanita Jackson
- Credential
- PharmD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 31, 2025
- Certification date
- Mar 31, 2025
- Last updated
- Mar 31, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 051298463 | IL | Yes |
Practice location
111 S Halsted StChicago, IL 60661-3507
Phone 312-463-9142
Mailing address
111 S Halsted StChicago, IL 60661-3507
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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