Jackson, Denise L

Jackson, Denise L is an individual health care provider with primary practice located at 10043 W Lincoln Hwy , Frankfort IL 60423-1272. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Jackson, Denise L can be contacted via phone (708) 709-9300.

Contact Information

Primary practice address
10043 W Lincoln Hwy Frankfort IL 60423-1272
Phone: (708) 709-9300
Fax: (708) 709-6353
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036094604 Illinois

Profile Details

NPI number 1871545772
LBN Legal business name Jackson, Denise L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Oct 17th, 2012 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1871545772 NPPES
Illinois Other P00450388/C K6882 RAILROAD MEDICARE
Illinois Other 4673170001 RAILROAD MEDICARE

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