Individual
ERICA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
5569 W 95TH ST, OAK LAWN, IL 60453-2356
(708) 529-0278
Mailing address
11408 S MAY ST, CHICAGO, IL 60643-4532
(561) 601-8605
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.109387
IL
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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