MISS AMANI DIANNE JACKSON (NPI# 1962864447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962864447 |
| Entity Type | Individual |
| Full Name | MISS AMANI DIANNE JACKSON |
| Practice Address |
3631 213th St Matteson IL 60443-2510 |
| Mailing Address |
1020 Park Drive P.o. Box #725 Flossmoor IL 60422 |
| Practice Telephone | 7087244170 |
| Mailing Telephone | 7087244170 |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2016-03-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851873962 | Amani Jackson | Counselor | 470 E 3rd St, Los Angeles, CA 90013-1629 | 2018-09-05 |
| Street Address |
3631 213TH ST |
| City | MATTESON |
| State | IL |
| Zip Code | 60443-2510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821642497 | Natalie Donyelle Mitchell | Psychologist | 6202 Vollmer Rd Colin Powell Middle School, Elementary Sd 159, Matteson, IL 60443 | 2019-07-31 |
| 1881199909 | Christopher Anthony Smith | Student in an Organized Health Care Education/Training Program | 5660 Woodgate Dr, Matteson, IL 60443 | 2018-03-29 |
| 1336695253 | Renato Leano | Physical Therapist | 21020 Kostner Avenue, Matteson, IL 60443 | 2016-08-31 |
| 1669826657 | Heredeshee Latrice Taylor | Nurse Practitioner | 3201 Holden Cir, Matteson, IL 60443 | 2016-04-16 |
| 1366713125 | Rosanne Miller Tadsen | Counselor | 6201 Vollmer Rd, Matteson, IL 60443 | 2012-01-25 |
| 1598063281 | Sheri Temple | Occupational Therapist | 3906 212th Place, Matteson, IL 60443 | 2011-03-04 |
| 1013247576 | Sheila M. Pijus | Counselor | 336 Tullamore Ter., Matteson, IL 60443 | 2010-01-06 |
| 1962731190 | Benita Yvette Norwoord | Counselor | 600 Holiday Plaza, Matteson, IL 60443 | 2009-12-17 |
| 1386881654 | Reliance Home Health Services, Inc. | Home Health | 4350 W. Lincoln Hwy #210, Reliance Home Health Services, Inc., Matteson, IL 60443 | 2009-01-08 |
| 1518139286 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 5640 211th St., Matteson, IL 60443 | 2008-04-02 |
| Find all providers in zip 60443 | ||||
| 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 |
|---|---|---|---|---|
| 1881199909 | Christopher Anthony Smith | Student in an Organized Health Care Education/Training Program | 5660 Woodgate Dr, Matteson, IL 60443 | 2018-03-29 |
| 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 |
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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.