Albert L. Jackson DDS

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019011493 Issued in IL

Legal business name

ALBERT L. JACKSON DDS

Practice address

30 N Michigan Ave
Suite 1803
Chicago, IL 60602-3402

Phone

(312) 368-1600

Fax

(312) 368-1542

NPI assigned

Feb 26, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Albert L Jackson, DDS

Title

Dentist /Owner

Phone

(312) 368-1600

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1043489875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 1803",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023402",
            "telephone_number": "312-368-1600",
            "fax_number": "312-368-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 1803",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023402",
            "telephone_number": "312-368-1600",
            "fax_number": "312-368-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERT L. JACKSON DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST /OWNER",
        "authorized_official_telephone_number": "312-368-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019011493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Albers, SLP
• Bradley Mark Albers, M.D.
• Kelly Albers
• Agnieszka Alberska
• Kurt Alberson, MD
• Albert Pecherek SC.
• Albert R Rosanova Jr LTD
• Andrew Albert, MD
• Arielle Susan Albert, PH.D.
• David B Albert, PH.D.

• Dental Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.