Jackson, Damien
Jackson, Damien is an sole proprietor health care provider with primary practice located at 201 Maplewood Ave , Mundelein IL 60060-4129. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jackson, Damien can be contacted via phone (773) 234-4808.Contact Information
Primary practice address
201 Maplewood Ave
Mundelein IL 60060-4129
Phone: (773) 234-4808
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 149021097 | Illinois |
Profile Details
| NPI number | 1588256424 |
|---|---|
| LBN Legal business name | Jackson, Damien |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 10th, 2021 |
| Last updated | Feb 10th, 2021 - about 3 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.
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