Individual
ALAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2734 W 87TH ST, CHICAGO, IL 60652-3937
(773) 918-4700
(773) 313-3763
Mailing address
2734 W 87TH ST, CHICAGO, IL 60652-3937
(773) 918-4700
(773) 313-3763
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036081595
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036081595
—
IL
Enumeration date
12/01/2006
Last updated
07/02/2024
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