# STEPHANIE J. JACKSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1033375043
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 125053014 | IL | — |
| 2080S0012X | Pediatric Sleep Medicine Physician | 01071127A | IN | Yes |
| 2084N0402X | Neurology with Special Qualifications in Child Neurology Physician | 01071127 | IN | — |

## Other

- **Enumeration date:** 07/30/2008
- **Last updated:** 01/12/2021