ALBERT L. JACKSON DDS NPI 1043489875

NPI Information

NPI: 1043489875
Provider Name: ALBERT L. JACKSON DDS
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
30 N MICHIGAN AVE
SUITE 1803
CHICAGO, IL
ZIP 60602
Phone: (312) 368-1600
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ALBERT L. JACKSON DDS is a dental clinic center in Chicago, IL. ALBERT L. JACKSON DDS NPI is 1043489875. The provider is registered as an organization entity type.

The provider's business location address is:

30 N MICHIGAN AVE
SUITE 1803
CHICAGO, IL
ZIP 60602-402
Phone: (312) 368-1600
Fax: (312) 368-1542

The provider's authorized official is Albert L Jackson .
The authorized official title is Dentist /owner and has the following contact phone number (312) 368-1600.

The enumeration date for this NPI number is 2/26/2008 and was last updated on 2/26/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	019011493	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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