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Individual

ABBIGAIL JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(847) 588-3024
Mailing address
3860 W. OGDEN AVE, CHICAGO, IL 60623
(847) 588-3024

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041413434
IL
363L00000X
Nurse Practitioner
Primary
209.014952
IL

Other

Enumeration date
09/23/2016
Last updated
04/05/2017
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