Jackson, Lori R

Jackson, Lori R is an individual health care provider with primary practice located at 1701 Curtis Rd , Champaign IL 61822-9678. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Jackson, Lori R can be contacted via phone (217) 365-6201.

Contact Information

Primary practice address
1701 Curtis Rd Champaign IL 61822-9678
Phone: (217) 365-6201
Fax: (217) 326-4003
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036119598 Illinois

Profile Details

NPI number 1154533271
LBN Legal business name Jackson, Lori R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated Dec 21st, 2017 - about 7 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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