Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kenneth Jackson, PHD

Individual provider Clinical Psychologist · NPI 1588762108

Dr. Kenneth Jackson, PHD is a Clinical Psychologist in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois and Indiana.

Licensed in
IL, IN
In the registry since
2006
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

5701 N Ashland Ave Ste 205-A
Chicago, IL 60660-4027
Phone: (773) 454-7202
Fax: (773) 465-5041
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 071007090 (IL)
Health Service Psychologist Taxonomy 103TH0100X · Licence 20042218A (IN)

Record details

NPI number1588762108
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedSeptember 20, 2006
Last updated in NPPESNovember 4, 2010

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