JEFFREY JACKSON (NPI# 1578193181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578193181 |
| Entity Type | Individual |
| Full Name | JEFFREY JACKSON |
| Practice Address |
1055 W Longfellow Dr Manteno IL 60950-9472 |
| Practice Telephone | 8155492955 |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | WI | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881259570 | Jeffrey Lamar Jackson II | Chiropractor | 13865 S Dixie Hwy # 307, Miami, FL 33176-7221 | 2019-05-08 |
| 1548753965 | Jeffrey Jackson | Social Worker | 2024 Corporate Centre Dr Ste 103, Myrtle Beach, SC 29577-7410 | 2018-06-11 |
| 1154792422 | Jeffrey Scott Jackson | Occupational Therapy Assistant | 3209 Bristol Hwy., Nhc Healthcare, Johnson City, TN 37601 | 2015-10-13 |
| 1447481205 | Jeffrey Brown Jackson | Marriage & Family Therapist | 450 N University Ave, Suite 204, Provo, UT 84601-2860 | 2009-07-28 |
| 1952421927 | Jeffrey W Jackson | Pharmacist | 5510 Lafayette Rd Ste 260, Indianapolis, IN 46254-1691 | 2007-03-30 |
| 1659432607 | Jeffrey L Jackson | Internal Medicine | 500o W National Ave, Milwaukee, WI 53295-0001 | 2006-12-13 |
| 1760589477 | Jeffrey Scott Jackson | Pharmacist | 16821 Rosman Hwy, Lake Toxaway, NC 28747-9593 | 2006-09-17 |
| 1194764860 | Jeffrey Kline Jackson | Family Medicine | 2200 W Touhy Ave, Chicago, IL 60645-3412 | 2006-06-06 |
| 1972563443 | Jeffrey A Jackson | Internal Medicine | 720 Eskenzi Ave., Indianapolis, IN 46202-5166 | 2006-03-27 |
| 1033759154 | Jeffrey Frank Jackson | Nurse Anesthetist, Certified Registered | 2142 N Cove Blvd, Toledo, OH 43606-3895 | 2020-01-07 |
| Street Address |
1055 W LONGFELLOW DR |
| City | MANTENO |
| State | IL |
| Zip Code | 60950-9472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710344338 | Specialized Assistance Services, Nfp | Clinic/Center | 333 W Evergreen St, Manteno, IL 60950 | 2016-01-27 |
| 1588004667 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 175 Evergreen, Manteno, IL 60950 | 2013-07-03 |
| 1649610841 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 325 Hemlock, Manteno, IL 60950 | 2013-07-02 |
| 1811337280 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 215 Hemlock, Manteno, IL 60950 | 2013-07-01 |
| 1407296981 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 365 Hemlock, Manteno, IL 60950 | 2013-06-28 |
| 1760822142 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 185 Chestnut, Manteno, IL 60950 | 2013-06-28 |
| 1598105975 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 280 Ironwood, Manteno, IL 60950 | 2013-06-28 |
| 1942640339 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 360 Ironwood, Manteno, IL 60950 | 2013-06-28 |
| 1215377692 | Nexus Family Healing | Residential Treatment Facility, Emotionally Disturbed Children | 110 Evergreen, Manteno, IL 60950 | 2013-06-28 |
| 1972862787 | Karl A Keller | Dentist | 312 W. Division, Manteno, IL 60950 | 2012-05-14 |
| Find all providers in zip 60950 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720436 | April Renee Gallik | Student in an Organized Health Care Education/Training Program | 8807 S 79th Ave Apt 18, Hickory Hills, IL 60457-1597 | 2020-11-03 |
| 1932709706 | Samantha Klosak | Student in an Organized Health Care Education/Training Program | 8144 Old Mill Rd, Frankfort, IL 60423-8675 | 2020-10-29 |
| 1508466624 | Carly Belle Mitchell | Student in an Organized Health Care Education/Training Program | 870 Appletree Ct, Northbrook, IL 60062-3402 | 2020-10-28 |
| 1144829813 | Payton Collins | Student in an Organized Health Care Education/Training Program | 5103 S Brookstone Dr, Rochelle, IL 61068-9131 | 2020-10-22 |
| 1821697830 | Mayuri Prashant Shende | Student in an Organized Health Care Education/Training Program | 2160 S. First Ave., Bldg. 105, Suite 2840a, Marywood, IL 60135 | 2020-10-21 |
| 1922607001 | Katherine Chen | Student in an Organized Health Care Education/Training Program | 2305 Mohawk Ln, Glenview, IL 60026-1035 | 2020-10-20 |
| 1922606995 | Cassia Yuechun Weigel | Student in an Organized Health Care Education/Training Program | 601 N Main St Apt 5s, Normal, IL 61761-1576 | 2020-10-13 |
| 1679171888 | Manuel J Ramirez | Student in an Organized Health Care Education/Training Program | 714 W Woodland Rd, Lake Bluff, IL 60044-1652 | 2020-10-12 |
| 1205443975 | Nickolas Armstrong | Student in an Organized Health Care Education/Training Program | 2828 N Pine Grove Ave Apt 618, Chicago, IL 60657-6137 | 2020-09-28 |
| 1871109496 | Morgan Elizabeth Westjohn | Student in an Organized Health Care Education/Training Program | 111 Mound St, Sainte Marie, IL 62459 | 2020-09-18 |
| 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.