Deanna Jackson
Nurse Practitioner, Psych/Mental Health in Chicago, IL. Individual provider (NPI-1).
NPI number1548055239
StatusActive
Last updated in NPPESApr 12, 2025
Details
- NPI
- 1548055239
- Entity type
- Individual (NPI-1)
- Name
- Deanna Jackson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 12, 2025
- Certification date
- Apr 12, 2025
- Last updated
- Apr 12, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 209032018 | IL | Yes |
Practice location
164 N Peoria St Apt 2101Chicago, IL 60607-2368
Phone 708-545-7415
Mailing address
164 N Peoria St Apt 2101Chicago, IL 60607-2368
Phone 708-545-7415
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