Individual
IYANNA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AADP
Contact information
Practice address
125 E 103RD ST, CHICAGO, IL 60628-2713
(312) 554-9177
Mailing address
125 E 103RD ST, CHICAGO, IL 60628-2713
(773) 858-2837
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
—
—
Other
Enumeration date
12/05/2024
Last updated
04/19/2025
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