DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. JACKIE LOU ANDERSON

Active Sole Proprietor

MRS. JACKIE LOU ANDERSON is a Developmental Therapist healthcare provider located in MACHESNEY PARK, Illinois. NPI 1295004406 is currently active in the NPPES registry. Verify at CMS.

Developmental Therapist · MACHESNEY PARK, IL

Registration Details

NPI Number
1295004406
Provider Type
Individual
Gender
Female
NPI Issued
Dec 16, 2011 (14.674721583107 yrs)
Last Updated
Dec 16, 2011
Sole Proprietor
Yes

Practice Information

Address
101 SHORELAND RD
MACHESNEY PARK, IL, 611152833
Browse IL providers · Browse ZIP 61115
Phone
8156331173
Primary Specialty
Developmental Therapist
222Q00000X

Other Developmental Therapist Providers in MACHESNEY PARK, IL

Name Credential NPI
MRS. MARY KATHLEEN JAVUREK LEE DT/DTH 1366578692
MRS. NOEL ELIZABETH RYALL 1306455357
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.