Individual
FELICIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7026 W BELDEN AVE UNIT B, CHICAGO, IL 60707-2966
(773) 398-0595
Mailing address
7026 W BELDEN AVE UNIT B, CHICAGO, IL 60707-2966
(773) 398-0595
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041462331
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041462331
—
IL
Enumeration date
12/31/2019
Last updated
12/31/2019
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