Individual provider

MS. DEBORAH LEE JACKSON, LCSW

CMS NPPES lists MS. DEBORAH LEE JACKSON as an individual provider record with NPI 1003006842. The current record reports a primary practice location in CHICAGO, IL and primary taxonomy code 1041C0700X.

NPI 1003006842Record type Type 1Primary taxonomy 1041C0700X

Type 1 NPIs identify individual healthcare providers. How to read this profile

01

Practice locations

  1. Primary practice location
    2820 W PETERSON AVECHICAGO, IL 606593803

Only source-designated practice locations are shown here. Mailing addresses are not presented as practice locations.

02

Taxonomy information

  • 1041C0700XPrimary reported taxonomy

Taxonomy codes describe provider classifications reported to NPPES. Repeated identical codes are shown once, with primary-reported status preserved. They are not licenses, certifications, quality measures, or NPIFolio specialty labels. Read the taxonomy methodology.

03

NPI record information

NPI status
Enumerated in NPPES
Enumeration date
July 27, 2007

An NPI is a federal identifier. Enumeration and lifecycle information does not establish medical-license status, current practice, disciplinary history, provider quality, or whether a provider is accepting patients.