IndividualActive
Annie Jackson
NPI 1700338712 · Home Health Aide · Phoenix, IL
Provider details
- NPI number
- 1700338712
- Entity type
- Individual
- Primary specialty
- Home Health AideNursing Service Related Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 043068868 (IL)
Specialties & taxonomies
Nursing Service Related Providers
Practice location
517 E 153rd St
Phoenix, IL 60426-2308
Phone: (708) 513-2866
Approximate (ZIP-level) locationGet directions
Mailing address
517 E 153rd St
Phoenix, IL 60426-2308
Registry dates
- Enumerated
- 2016-10-26
- Last updated
- 2016-10-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.