DR. DAVID JACKSON (NPI# 1003456708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003456708 |
| Entity Type | Individual |
| Full Name | DR. DAVID JACKSON |
| Credential | MD |
| Practice Address |
6 Parkway North Blvd Deerfield IL 60015-2522 |
| Practice Telephone | 4804663423 |
| Practice Fax Number | 5412291293 |
| Mailing Telephone | 4804663423 |
| Mailing Fax Number | 5412291293 |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2020-01-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194160580 | David Huntsman Jackson | Internal Medicine | 3647 Dunbarton Dr, Mountain Brk, AL 35223-2891 | 2013-04-30 |
| 1790089860 | David Creston Jackson | Dentist | 900 Se Ocean Blvd Ste 110b, Stuart, FL 34994-3503 | 2011-01-05 |
| 1851566467 | David Kenneth Jackson | Technician/Technologist | 4200 Elderon Ave, Baltimore, MD 21215-4802 | 2008-04-24 |
| 1275711350 | David Edward Jackson IIi | Massage Therapist | 3321 E 35th Ave, Lake Station, IN 46405-3016 | 2008-01-31 |
| 1548456502 | David Nathan Jackson | Physical Therapist | 7922 S Broadway Ave, Tyler, TX 75703-5242 | 2007-09-23 |
| 1063564748 | David Bruce Jackson | Radiology | 3233 Grand Ave # N415, Chino Hills, CA 91709-1489 | 2007-01-16 |
| 1912079641 | David Christopher Jackson | Chiropractor | 484 Turner Dr, Building E, Suite 103, Durango, CO 81303-7992 | 2006-11-15 |
| 1316017940 | David Isaac Jackson | Counselor | 946 Edgewood Ave, Trenton, NJ 08618-5304 | 2006-11-09 |
| 1629165170 | David Michael Jackson | Dentist | 3550 S 5600 W, Suite 3, West Valley City, UT 84120-2776 | 2006-10-06 |
| 1366544322 | David Max Jackson | Speech-Language Pathologist | 81 Peregrine Ct, W Lafayette, IN 47906-5073 | 2006-09-01 |
| Street Address |
6 PARKWAY NORTH BLVD |
| City | DEERFIELD |
| State | IL |
| Zip Code | 60015-2522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467073569 | Steven A Ditgen | Physical Therapist | 43 N. Waukegan Road, Deerfield, IL 60015 | 2020-04-29 |
| 1760017255 | Amanda Barkley | Pharmacist | 200 Wilmont Rd, Deerfield, IL 60015 | 2020-03-05 |
| 1467001487 | Nora Fahmi | Pharmacist | Walgreen Co., 200 Wilmot Road, Deerfield, IL 60015 | 2019-09-11 |
| 1477105187 | Anthony Greis | Obstetrics & Gynecology | 540 Lake Cook Road, Suite 300, Deerfield, IL 60015 | 2019-07-12 |
| 1528628484 | Cynthia Lynne Mckinzie | Psychologist | The Neuroscience Center, 440 Lake Cook Road, Deerfield, IL 60015 | 2019-06-13 |
| 1073084497 | Mary Jeane Jeane Velez | Nurse Practitioner | Brentwood Rehabilitation Center, 3705 Deerfield Rd., Deerfield, IL 60015 | 2018-12-11 |
| 1891264644 | Smile On of North Shore, PC | Dentist | 707 Lake Cook Rd., Suite 121, Deerfield, IL 60015 | 2018-11-21 |
| 1497236376 | Linda Li | Counselor | 15 Parkway North Blvd, Deerfield, IL 60015 | 2018-08-28 |
| 1174009831 | Rachael Michelle Lynn | Physician Assistant | 1302 Hazel Ave, Deerfield, IL 60015 | 2018-07-16 |
| 1730675182 | Alexandra Lee Joseph | Social Worker | 420 Lake Cook Road, Suite 113, Deerfield, IL 60015 | 2018-07-09 |
| Find all providers in zip 60015 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285297069 | Northwest Suburban Psychology, LLC | Clinical Neuropsychologist | 1020 Milwaukee Ave, Deerfield, IL 60015-3513 | 2019-04-17 |
| 1558777987 | Victoria Tuchscherer | Clinical Neuropsychologist | 1020 Milwaukee Ave, Deerfield, IL 60015-3513 | 2014-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477183556 | Michelle Yvonne Kibby-faglier | Clinical Neuropsychologist | 285 Lake Indian Hills Dr, Carbondale, IL 62902-6184 | 2020-01-17 |
| 1649830159 | Natalie Berger | Clinical Neuropsychologist | 1645 W Jackson Blvd Ste 203, Chicago, IL 60612-3227 | 2019-06-17 |
| 1043877475 | Sarah Mailander Dyer | Clinical Neuropsychologist | 900 Royal Heights Rd Ste 14, Belleville, IL 62226-5457 | 2019-05-21 |
| 1639655632 | Julia Digangi | Clinical Neuropsychologist | 920 N York Rd, Hinsdale, IL 60521-2996 | 2018-07-13 |
| 1891211710 | Kenneth Vicencio | Clinical Neuropsychologist | 4100 Healthway Drive, Aurora, IL 60504 | 2017-08-22 |
| 1538690466 | Kathleen Ares | Clinical Neuropsychologist | 4440 W 95th, Suite 1200h, Oak Lawn, IL 60453 | 2017-03-22 |
| 1225575871 | Israel Gross | Clinical Neuropsychologist | 1934 W. Roscoe St., #4, Chicago, IL 60657 | 2017-01-20 |
| 1013462829 | Ann Westcot Jordan | Clinical Neuropsychologist | 21037 Benjamin Dr, Shorewood, IL 60404-0612 | 2016-08-22 |
| 1740638915 | Elizabeth Regina Tuminello Hartman | Clinical Neuropsychologist | 1875 Dempster St Ste 520, Park Ridge, IL 60068-1130 | 2016-05-29 |
| 1144680703 | Brenda Henderson | Clinical Neuropsychologist | 7958 S Michigan Ave, Chicago, IL 60619-3509 | 2016-02-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.