Ms. Deborah Lee Jackson
Clinical Social Worker
2820 W Peterson Ave
Chicago
, Illinois 60659-3803
Ms. Deborah Lee Jackson
Clinical Social Worker
2820 W Peterson Ave
Chicago
, Illinois 60659-3803
(773) 728-4751
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About
Features
Specialties
- Clinical Social Worker
Languages spoken
- English
Location
First Address
- Ms. Deborah Lee Jackson
- 2820 W. Peterson Ave
- Chicago, IL
- Zip : 60659
- Fax : (773) 728-4751
- Phone : (773) 293-8437
Second Address
- Ms. Deborah Lee Jackson
- 2820 W Peterson Ave
- Chicago, IL
- Zip : 60659-3803
- Fax : (773) 728-4751
- Phone : (773) 293-8437
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1041C0700X | Clinical Social Worker | IL |
National Provider Identifier
| NPI | 1003006842 |
|---|---|
| Provider Name | Ms. Deborah Lee Jackson |
| First Address | Chicago, IL 60659 |
| Second Address | Chicago, IL 60659-3803 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/07/2007 |
| Last Update Date | 27/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.