Individual
JESSICA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
330 MADISON ST STE 104, JOLIET, IL 60435-6572
(815) 725-3440
Mailing address
330 MADISON ST STE 104, JOLIET, IL 60435-6572
(815) 725-3440
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085.005695
IL
Other
Enumeration date
10/12/2015
Last updated
05/10/2022
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