DR. HOWARD FRANKLIN JACKSON (NPI# 1255453718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255453718 |
Entity Type | Individual |
Full Name | DR. HOWARD FRANKLIN JACKSON |
Credential | DPM |
Practice Address |
4601 State St Suite 310 East Saint Louis IL 62205-1359 |
Practice Telephone | 6188757230 |
Practice Fax Number | 6188757230 |
Mailing Telephone | 6188757230 |
Mailing Fax Number | 6188757230 |
Enumeration Date | 2007-04-04 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
016003650 | IL | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 016003650 | 05 | |
IL | UNITED HEALTHCARE | 2780264 | 01 |
IL | RAILROAD MEDICARE | 480004788 | 01 |
IL | BLUE SHEILD | 0060101272 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902161243 | Howard Leslie Jackson | Residential Treatment Facility, Physical Disabilities | 7801 Airport Pulling Rd N, Naples, FL 34109-1717 | 2012-07-12 |
1689629891 | Howard Woodrow Jackson Jr. | Spec/Tech, Cardiovascular | 301 W Boundary Ave, Winnfield, LA 71483-3427 | 2006-05-24 |
1437149945 | Howard C Jackson Jr. | Family Medicine | 711 Green Rd, Madison, IN 47250-2199 | 2005-10-26 |
1255338042 | Howard B Jackson | Physical Medicine & Rehabilitation | 13020 N Telecom Pkwy, Temple Terrace, FL 33637-0925 | 2005-07-07 |
Street Address |
4601 STATE ST SUITE 310 |
City | EAST SAINT LOUIS |
State | IL |
Zip Code | 62205-1359 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558344986 | Gerard X Blaise | Dentist | 4601 State St, Ste 300, East Saint Louis, IL 62205-1359 | 2005-11-21 |
1013269737 | Illinois Express Home Care | In Home Supportive Care | 4601 State St, East Saint Louis, IL 62205-1359 | 2012-10-04 |
1427227891 | Comprehensive Mental Health Center of St. Clair County, Inc. | Community/Behavioral Health | 4601 State St, East Saint Louis, IL 62205-1359 | 2008-02-29 |
1801065289 | Comprehensive Mental Health Center of St. Clair County, Inc. | Community/Behavioral Health | 4601 State St, East Saint Louis, IL 62205-1359 | 2008-02-29 |
1437328812 | Comprehensive Mental Health Center of St. Clair County, Inc. | Clinic/Center | 4601 State St, East Saint Louis, IL 62205-1359 | 2008-02-29 |
1730358110 | Comprehensive Mental Health Center of St. Clair County, Inc. | Community/Behavioral Health | 4601 State St, East Saint Louis, IL 62205-1359 | 2008-02-29 |
1306853676 | Marshall Katzman | Psychiatry & Neurology | 4601 State St, East Saint Louis, IL 62205-1359 | 2006-08-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790156610 | Lessie Bates Davis Neighborhood House | Registered Nurse | 1200 North 13th Street, East Saint Louis, IL 62205 | 2015-10-19 |
1114047859 | Herschel Lee Garrett Jr. | Dentist | 4020 Caseyville Ave, East St Louis, IL 62205 | 2007-03-29 |
1376871103 | Toni M. Jackson | Massage Therapist | 4806 State St, Home Office, East Saint Louis, IL 62205-1355 | 2009-12-07 |
1811347362 | Destinee Hope Grove | Specialist/Technologist | 4901 State St, East Saint Louis, IL 62205-1356 | 2016-06-15 |
1053963470 | Stephanie Michelle Tate-patterson | Nurse Practitioner | 4901 State St, East Saint Louis, IL 62205-1356 | 2019-07-16 |
1710406962 | Christa R Dyson-spiller | Nurse Practitioner | 4901 State St, East Saint Louis, IL 62205-1356 | 2017-09-19 |
1740247360 | Dolores J Gunn | Family Medicine | 2001 State St, East Saint Louis, IL 62205-1803 | 2006-04-27 |
1184845257 | Rina S. Patney | Pediatrics | 2001 State St, East Saint Louis, IL 62205-1803 | 2007-05-02 |
1811054935 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 2001 State St, East Saint Louis, IL 62205-1803 | 2007-01-02 |
1245396886 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 2001 State St, East Saint Louis, IL 62205-1803 | 2006-12-28 |
Find all providers in zip 62205 |
Taxonomy Code | 213ES0131X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902269301 | Jillian Cabai | Podiatrist | 3000 N Halsted St Ste 606, Chicago, IL 60657-6456 | 2016-04-01 |
1710279641 | Prpodiatry, LLC | Podiatrist | 433 W Briar Pl, Unit 7b, Chicago, IL 60657-4752 | 2011-05-11 |
1205071149 | Bradley W. Buckrop Dpm | Podiatrist | 3727 46th Ave, Suite 103, Rock Island, IL 61201-7078 | 2008-12-05 |
1396919130 | Marwa Sayed | Podiatrist | 7255 W 87th St Unit 1, Bridgeview, IL 60455-1821 | 2008-04-14 |
1013191287 | Nikola Ivancevic Dpm PC | Podiatrist | 135 S Palmer Dr, Suite 105, Elmhurst, IL 60126-3403 | 2007-12-24 |
1659577575 | Pam Eernisse Dpm Sc | Podiatrist | 680 N Lake Shore Dr # 1305, Chicago, IL 60611-4546 | 2007-06-26 |
1720118367 | Larry Allen Keyes | Podiatrist | 1023 Madison St, Oak Park, IL 60302-4404 | 2007-03-06 |
1548399462 | Two Steps Ahead Podiatry, Inc. | Podiatrist | 1001 E Wilson St Ste 180, Batavia, IL 60510-3168 | 2007-03-05 |
1447392972 | Willie Lee Brown | Podiatrist | 10700 Lincoln Trl, Suite E, Fairview Heights, IL 62208-2037 | 2007-02-12 |
1972685410 | Nikola Ivancevic | Podiatrist | 5646 St Charles Rd, Suite B, Berkeley, IL 60163 | 2006-10-20 |
Find all providers with the same taxonomy |
City | EAST SAINT LOUIS |
Zip Code | 62205 |
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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.