Felicia Jackson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041462331 Issued in IL

Practice address

7026 W Belden Ave Unit B
Chicago, IL 60707-2966

Phone

(773) 398-0595

NPI assigned

Dec 31, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1053950543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7026 W BELDEN AVE UNIT B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607072966",
            "telephone_number": "773-398-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7026 W BELDEN AVE UNIT B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607072966",
            "telephone_number": "773-398-0595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 N Ashland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606071802",
            "country_code": "US",
            "telephone_number": "773-398-0595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "FELICIA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-31",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041462331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041462331",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "fefej21@gmail.com",
            "affiliation": "N",
            "address_1": "140 N Ashland Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606071802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deanna Jackson
• Deborah Lee Jackson, LCSW
• Devonna Jackson, MA, LCPC
• Ecola Jackson, CPHT
• Evan Leigh Jackson, DO
• Gabrielle Tynisha Jackson
• Gale Victoria Jackson, NP
• Gregory Wayne Jackson, DDS
• Ida B Jackson, LCPC,
• Iris Yvonne Jackson

• Registered Nurse in Chicago, IL
• Providers in Chicago, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.