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NPI Profile for JESSICA JACKSON in JOLIET, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI # | 1780055285 |
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| Status | Active | |
| Credentials | PA-C (Physician Assistant-Certified) | |
| Entity | Individual | |
| Enumeration date | 10/12/2015 | |
| Last updated | 05/10/2022 - About 4 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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| Hospital affiliation(s) |
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JESSICA JACKSON
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JESSICA JACKSON, PA-C