Individual
FRAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 RILEY AVE, LOCKPORT, IL 60441-5110
(779) 456-5813
Mailing address
105 RILEY AVE, LOCKPORT, IL 60441-5110
(815) 600-2282
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
02/13/2022
Last updated
03/14/2022
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