Individual
FELICIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
450 W 14TH ST, CHICAGO HEIGHTS, IL 60411-2463
(708) 985-3040
Mailing address
8745 S THROOP ST, CHICAGO, IL 60620-3434
(773) 630-4569
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/07/2020
Last updated
04/07/2020
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