MISS DIANA DEAN JACKSON M.S. NPI 1225247752

NPI Information

NPI: 1225247752
Provider Name: MISS DIANA DEAN JACKSON, M.S.
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
6133 ELM LN
MATTESON, IL
ZIP 60443
Phone: (708) 720-1621
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MISS Diana Dean Jackson, M.S. is a specialist in Matteson, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MISS Diana Dean Jackson, M.S. NPI is 1225247752. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6133 ELM LN
MATTESON, IL
ZIP 60443-321
Phone: (708) 720-1621
Fax: (708) 720-1621

The enumeration date for this NPI number is 5/22/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist			ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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