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Individual
STEPHANIE J. JACKSON
Active
Individual
STEPHANIE J. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
125053014
IL
2080S0012X
Pediatric Sleep Medicine Physician
Primary
01071127A
IN
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
01071127
IN
Other
Enumeration date
07/30/2008
Last updated
01/12/2021
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