Jackson, Robert Leon

Jackson, Robert Leon is an sole proprietor health care provider with primary practice located at 1201 S Veterans Pkwy Suite B, Springfield IL 62704-6321. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jackson, Robert Leon can be contacted via phone (217) 793-2770.

Contact Information

Primary practice address
1201 S Veterans Pkwy Suite B Springfield IL 62704-6321
Phone: (217) 793-2770
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X Illinois

Profile Details

NPI number 1104032952
LBN Legal business name Jackson, Robert Leon
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 15th, 2007
Last updated Jul 8th, 2007 - about 17 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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