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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

DEBORAH L JACKSON, LCSW
2820 W PETERSON AVE
CHICAGO, IL60659-3803
 Phone: 773-293-8437
 Fax: 773-728-4751
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for DEBORAH L JACKSON · (Female)

NPI Number 1003006842
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 07/27/2007
Last updated 07/27/2007 - About 12 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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