Jackson, Addison
Jackson, Addison is an sole proprietor health care provider with primary practice located at 4137 Sauk Trl Ste 146 , Richton Park IL 60471-1253. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jackson, Addison can be contacted via phone (708) 983-8074.Contact Information
Primary practice address
4137 Sauk Trl Ste 146
Richton Park IL 60471-1253
Phone: (708) 983-8074
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 149.021059 | Illinois |
Profile Details
| NPI number | 1821648668 |
|---|---|
| LBN Legal business name | Jackson, Addison |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 13th, 2019 |
| Last updated | Mar 9th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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