Individual
DR. ADAM JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BMSCD, MBSC, CNIM
Contact information
Practice address
55 W CHESTNUT ST, CHICAGO, IL 60610-3347
(615) 732-9343
Mailing address
55 W CHESTNUT ST APT 2208, CHICAGO, IL 60610-3345
Taxonomy
Speciality
Code
Description
License number
State
173F00000X
Sleep Specialist (PhD)
Primary
—
—
204R00000X
Electrodiagnostic Medicine Physician
2045
IL
2084N0600X
Clinical Neurophysiology Physician
2045
TN
Other
Enumeration date
03/06/2017
Last updated
04/25/2020
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