National Provider Identifier Database

JESSICA JACKSON, PA-C – NPI #1780055285
Surgical


Contact Information

JESSICA JACKSON, PA-C
330 MADISON ST STE 104
JOLIET, IL60435-6572
Phone: 815-725-3440
Fax:
Website:
Specialty Taxonomy Code
* Surgical 363AS0400X

* Indicates primary specialty

NPI Profile & details for JESSICA JACKSON

NPI Number 1780055285
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 10/12/2015
Last updated 05/10/2022 - About 4 years ago
Sole proprietor1 Yes
Identifiers
  • IL License #: 085.005695
Hospital affiliation n/a

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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