Jeffrey Jackson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1578193181

Jeffrey Jackson is a Student in an Organized Health Care Education/Training Program in Manteno, Illinois. Licensed in Wisconsin. Registered with an NPI since 2020.

Licensed in: WI
In the registry since: 2020

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Practice location Address checks out

1055 W Longfellow Dr
Manteno, IL 60950-9472
Phone: (815) 549-2955

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary)	Taxonomy 390200000X (WI)

Record details

NPI number	1578193181
Entity type	Individual (Type 1)
Gender	Male
Sole proprietor	No
NPI enumerated	January 22, 2020
Last updated in NPPES	January 22, 2020
Certification date	January 22, 2020
Mailing address	1055 W Longfellow Dr, Manteno, IL 60950-9472