Jackson, Cheryl
Jackson, Cheryl is an individual health care provider with primary practice located at 233 Washington St , Woodstock IL 60098-3399. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Jackson, Cheryl can be contacted via phone (815) 338-0674.Contact Information
Primary practice address
233 Washington St
Woodstock IL 60098-3399
Phone: (815) 338-0674
Fax: (815) 338-6139
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046008108 | Illinois |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 046008108 | Illinois |
Profile Details
| NPI number | 1215019864 |
|---|---|
| LBN Legal business name | Jackson, Cheryl |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Apr 8th, 2015 - about 9 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215019864 | NPPES |
| Illinois | MEDICAID | 046008108 |
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