Jackson, Kevin M

Jackson, Kevin M is an sole proprietor health care provider with primary practice located at 120 Spalding Dr Ste 308 , Naperville IL 60540-6521. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Jackson, Kevin M can be contacted via phone (630) 527-7730.

Contact Information

Primary practice address
120 Spalding Dr Ste 308 Naperville IL 60540-6521
Phone: (630) 527-7730
Fax: (630) 527-7197
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 01076371A Indiana
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 036111694 Illinois

Profile Details

NPI number 1821103581
LBN Legal business name Jackson, Kevin M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 20th, 2006
Last updated May 5th, 2021 - about 5 years ago

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 1821103581 NPPES
Indiana Other 01076371A LICENSE
Indiana MEDICAID 036111694 LICENSE

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