Jackson, Derrick
Jackson, Derrick is an sole proprietor health care provider with primary practice located at 4801 Southwick Dr Ste 300 , Matteson IL 60443-2279. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Jackson, Derrick can be contacted via phone (708) 747-2655.Contact Information
Primary practice address
4801 Southwick Dr Ste 300
Matteson IL 60443-2279
Phone: (708) 747-2655
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Community Health Worker | 172V00000X |
Profile Details
| NPI number | 1578261475 |
|---|---|
| LBN Legal business name | Jackson, Derrick |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 20th, 2023 |
| Last updated | Feb 20th, 2023 - about 2 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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