Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KENNETH JACKSON, PH.D.
Active Sole ProprietorDR. KENNETH JACKSON, PH.D. is a Clinical Psychologist healthcare provider located in CHICAGO, Illinois. NPI 1588762108 is currently active in the NPPES registry. Verify at CMS.
Clinical Psychologist · CHICAGO, IL
Registration Details
- NPI Number
- 1588762108
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 20, 2006 (19.893784112088 yrs)
- Last Updated
- Nov 4, 2010
- Licenses
-
071007090 (IL)20042218A (IN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5701 N ASHLAND AVESUITE 205-ACHICAGO, IL, 606604027Browse IL providers · Browse ZIP 60660
- Phone
- 7734547202
- Fax
- 7734655041
- Primary Specialty
-
Clinical Psychologist
103TC0700X
- Additional Specialty
- Health Service Psychologist
Other Clinical Psychologist Providers in CHICAGO, IL
| Name | Credential | NPI |
|---|---|---|
| DR. BARRY M LEAVITT | PSYD | 1588667315 |
| DR. RAY EDWARD QUACKENBUSH | PSY.D. | 1619970357 |
| DR. PAUL DALE LINDEN | PSY.D. | 1578568622 |
| DR. MARY ELIZABETH PAUL | PH.D. | 1366441917 |
| ANNE R WOLFE | PHD | 1619977907 |
| CRAIG WHITNEY JOCK | PSYD | 1407857873 |
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.