Individual
PRISCILLA EARLINE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NMD
Contact information
Practice address
2720 S HIGHLAND AVE APT 501, LOMBARD, IL 60148-5368
(630) 741-2846
Mailing address
2720 S HIGHLAND AVE APT 501, LOMBARD, IL 60148-5368
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
175F00000X
Naturopath
Primary
1130
MN
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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