Kenneth Jackson is a Clinical in Chicago, Illinois. Kenneth Jackson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kenneth Jackson is 1588762108. The last update date is 2010-11-04.
Kenneth Jackson's current location address is 5701 N Ashland Ave, Chicago, Illinois. You can contact this provider via phone number 7734547202 and fax number 7734655041. The mailing address for Kenneth Jackson is 5701 N Ashland Ave, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Jackson |
|---|---|
| Address | 5701 N Ashland Ave, Chicago, Illinois |
| Phone Number | 7734547202 |
| Fax Number | 7734655041 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1588762108 |
|---|---|
| Provider Enumeration Date | 2006-09-20 |
| Last Updated Date | 2010-11-04 |
Provider Mailing Address Detail
| Address | 5701 N Ashland Ave |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606604027 |
| Phone Number | 7734547202 |
| Fax Number | 7734655041 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 71007090 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Post Comment/ Review Below
What is the unique 10-digit identification code issued to Kenneth Jackson by the Centers for Medicare & Medicaid Services?
The Kenneth Jackson has been assigned the NPI (National Provider Identifier) 1588762108 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Kenneth Jackson's facilities are geographically located?
The facilities of Kenneth Jackson are physically situated at the following location: 5701 N Ashland Ave, Chicago, IL, 606604027.
What is the area of specialization for Kenneth Jackson, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Kenneth Jackson is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 103Tc0700X.
On what date did the Kenneth Jackson receive its 1588762108 assignment from the Centers for Medicare & Medicaid Services?
The Kenneth Jackson was assigned its 1588762108 by the Centers for Medicare & Medicaid Services on 2006-09-20.
When was the information regarding Kenneth Jackson most recently updated?
The details pertaining to the Kenneth Jackson, including its address, specialty, and other relevant information, were last refreshed on 2010-11-04.