Douglas-Jackson, Kesha

Douglas-Jackson, Kesha is an sole proprietor health care provider with primary practice located at 2160 S 1St Ave , Maywood IL 60153-3328. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Douglas-Jackson, Kesha can be contacted via phone (872) 231-3162.

Contact Information

Primary practice address
2160 S 1St Ave Maywood IL 60153-3328
Phone: (872) 231-3162
Fax: (708) 795-0101
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209016670 Illinois

Profile Details

NPI number 1720598071
LBN Legal business name Douglas-Jackson, Kesha
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 1st, 2017
Last updated Oct 8th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720598071 NPPES
Illinois Other 041410556 REGISTERED NURSE

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