Individual
ALISHIA JACKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3330 SKOKIE VALLEY RD STE 200, HIGHLAND PARK, IL 60035-1041
(847) 386-7744
Mailing address
650 MARYVILLE UNIVERSITY DR, SAINT LOUIS, MO 63141-5849
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2023032208
MO
363LF0000X
Family Nurse Practitioner
Primary
209028406
IL
Other
Enumeration date
09/21/2023
Last updated
10/22/2024
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