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

Individual provider Physical Therapy Assistant · NPI 1982333472

Gabrielle Elyse Jackson is a Physical Therapy Assistant in Sullivan, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2022
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Practice location Address checks out

1 Masonic Way
Sullivan, IL 61951-9467
Phone: (217) 728-3700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 160.007936 (IL)

Record details

NPI number1982333472
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 9, 2022
Last updated in NPPESJune 9, 2022
Certification dateJune 9, 2022
Mailing address2128 E 1525 North Rd, Shelbyville, IL 62565-4537

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