DELOVELY GLORIA JACKSON (NPI# 1013370857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013370857 |
| Entity Type | Individual |
| Full Name | DELOVELY GLORIA JACKSON |
| Credential | FNP |
| Practice Address |
18101 Cherrywood Ln Homewood IL 60430-1504 |
| Practice Telephone | 7087686902 |
| Mailing Telephone | 7087686902 |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-05-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209013987 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FPN MEDICARE PTAN | F400298104 | 01 |
| Street Address |
18101 CHERRYWOOD LN |
| City | HOMEWOOD |
| State | IL |
| Zip Code | 60430-1504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831702307 | Sms Dental LLC | Dentist | 17727 Halsted St, Homewood, IL 60430 | 2020-08-25 |
| 1619431020 | Jewish Child and Family Services | Clinic/Center | 1800 Ridge Road, Unit 204, Suite 4, Homewood, IL 60430 | 2019-01-30 |
| 1437636966 | Miracle Healthcare LLC | Clinic/Center | 2024 Hickory Rd Ste 306, Homewood, IL 60430 | 2018-07-26 |
| 1518443381 | Elizabeth Carol Rodgers | Developmental Therapist | 2820 Willow Rd, Homewood, IL 60430 | 2018-07-16 |
| 1114431764 | Kyla Shaneek O'neal | Counselor | 935 175th St Ste 300, Homewood, IL 60430 | 2017-11-17 |
| 1699221986 | Visionworks Inc | Eyewear Supplier (Equipment, not the service) | 17723 S Halsted St, Homewood, IL 60430 | 2016-08-28 |
| 1528420155 | Nathan Patrick Lagacy | Counselor | 3650 W. 183rd St., Homewood, IL 60430 | 2016-03-23 |
| 1891175725 | Quaneta Gates | Homeopath | 18216 Harwood Ave Unit 1 S, Homewood, IL 60430 | 2015-06-05 |
| 1164817334 | Shachi Pandya | Family Medicine | 18350 Kedzie Ave Ste 101, Homewood, IL 60430 | 2015-04-03 |
| 1790182327 | Floss Dental Care LLC | Preferred Provider Organization | 18650 Dixie Highway, Homewood, IL 60430 | 2014-11-25 |
| Find all providers in zip 60430 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902412604 | Roshana M Brown | Nurse Practitioner | 19012 Jodi Ter, Homewood, IL 60430-4208 | 2020-09-17 |
| 1659996791 | Lyons & Associates Family Care, Pllc | Nurse Practitioner | 1 Independence Plz Ste 414, Homewood, AL 35209-2650 | 2020-06-15 |
| 1255810966 | Kynyahta L Walters | Nurse Practitioner | 17901 Governors Hwy Ste 204, Homewood, IL 60430-1146 | 2018-08-13 |
| 1245749563 | Jamilla Brooks | Nurse Practitioner | 18903 Center Ave, Homewood, IL 60430-4201 | 2017-09-29 |
| 1144694829 | Benedeth Ndidi Nwumeh | Nurse Practitioner | 1155 183rd St, Homewood, IL 60430-3507 | 2015-11-18 |
| 1598171274 | Christy Greenhalgh | Nurse Practitioner | 1944 28th Ave S, Homewood, AL 35209 | 2014-07-02 |
| 1487255568 | Ashley Lillian Locus | Nurse Practitioner | 17901 Governors Hwy Ste 204, Homewood, IL 60430-1146 | 2020-11-04 |
| 1477168326 | Jaclyn Mariev Mcpheeters | Nurse Practitioner | 17960 Halsted St, Homewood, IL 60430-2014 | 2020-09-08 |
| 1992327506 | Christine A Offerman-izzarelli | Nurse Practitioner | 17901 Governors Hwy Ste 206, Homewood, IL 60430-1146 | 2020-05-18 |
| 1205464187 | Jeffrey Dan Intud | Nurse Practitioner | 17901 Governors Hwy Ste 206, Homewood, IL 60430-1146 | 2020-03-27 |
| Find all providers in HOMEWOOD | ||||
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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.