Quanisha Jackson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

21000 S Frankfort Square Rd Ste D
Frankfort, IL 60423-9386

Phone

(815) 469-1500

NPI assigned

Jan 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Westside Childrens Therapy

  • Physical Therapist
  • Joliet, IL
  • NPI 1972783900
  NPD (past)

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1124592217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12535 S CENTRAL AVE APT 1A",
            "city": "ALSIP",
            "state": "IL",
            "postal_code": "608033347",
            "telephone_number": "773-559-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 S FRANKFORT SQUARE RD STE D",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604239386",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "QUANISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Instantpharmacy LLC
• Integrative Diagnostics
• Internal Medicine Physicians Inc.
• Tasnim Jaber
• Denise L Jackson, M.D.
• Tiara Jackson, LPC
• Nora Jaffal
• Zachary G Jagmin, DPM
• Kishor Nathmal Jain, MD
• Samantha Jain, MD

• Behavior Technician in Frankfort, IL
• Providers in Frankfort, IL by specialty
• Behavior Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.