Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL K JACKSON, MASTERS
Active Sole ProprietorMICHAEL K JACKSON, MASTERS is a Adolescent and Children Mental Health Clinic healthcare provider located in ELDORADO, Illinois. NPI 1669236477 is currently active in the NPPES registry. Verify at CMS.
Adolescent and Children Mental Health Clinic · ELDORADO, IL
Registration Details
- NPI Number
- 1669236477
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 12, 2024 (2.4572149745644 yrs)
- Last Updated
- Feb 12, 2024
- Sole Proprietor
- Yes
Practice Information
- Address
-
1200 LOCUST STELDORADO, IL, 629301723Browse IL providers · Browse ZIP 62930
- Phone
- 6182529036
- Primary Specialty
-
Adolescent and Children Mental Health Clinic
261QM0855X
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.