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1245703354
SHAWNTELL JACKSON
CHICAGO, IL
NPI
1245703354
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209.01833)
Enumeration Date
2019-01-10
Last Update Date
2022-10-31
Business Address
SHAWNTELL JACKSON MSN,FNP-BC
2535 SOUTH MARTIN LUTHER KING DRIVE
CHICAGO, IL 60616
Phone number: 312-842-7117
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Mailing Address
SHAWNTELL JACKSON MSN,FNP-BC
29373 NETWORK PL
CHICAGO, IL 60673-1293
Phone number: 847-390-5900
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