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Individual

MRS. ROBIN JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
21121 CHRISTINA DR, MATTESON, IL 60443-3003
(312) 218-7409
Mailing address
21121 CHRISTINA DR, MATTESON, IL 60443-3003
(312) 218-7409

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
041413313
IL
163WP0808X
Psychiatric/Mental Health Registered Nurse
28208253A
IN

Other

Enumeration date
06/12/2019
Last updated
06/12/2019
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