Individual
DR. EVAN LEIGH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
808 SOUTH WOOD STREET, 469 CME, M/C 724, CHICAGO, IL 60612
(312) 413-7492
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02006363A
IN
207P00000X
Emergency Medicine Physician
Primary
036155621
IL
207P00000X
Emergency Medicine Physician
125.073354
IL
Other
Enumeration date
03/26/2018
Last updated
04/30/2025
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