Jackson, Shamika

Jackson, Shamika is an individual health care provider with primary practice located at 2213 Cheshire Dr , Aurora IL 60502-6938. She recently has only one registered license in Other Service Providers / Driver, which is considered as her primary health care specialty. Jackson, Shamika can be contacted via phone (773) 595-7828.

Contact Information

Primary practice address
2213 Cheshire Dr Aurora IL 60502-6938
Phone: (773) 595-7828
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Driver 172A00000X Illinois

Profile Details

NPI number 1265100879
LBN Legal business name Jackson, Shamika
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2021
Last updated Aug 31st, 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 1265100879 NPPES
Illinois MEDICAID 823160557

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