Individual
JENNIFER NICOLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 535-6150
Mailing address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 535-6150
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209005759
IL
363LA2100X
Acute Care Nurse Practitioner
209005759
IL
Other
Enumeration date
05/17/2007
Last updated
02/04/2020
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