Cheryl Jackson OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-008108 Issued in IL

Legal business name

CHERYL JACKSON OD PC

Doing business as

Cheryl Jackson OD PC

Practice address

10 E. Scranton Ave
Suite 203
Lake Bluff, IL 60044

Phone

(847) 234-7055

Fax

(847) 234-7166

NPI assigned

Dec 10, 2008

Last updated

Jan 23, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Cheryl Jackson, OD

Title

Owner, OD

Phone

(847) 234-7055

Specialties & licenses 1

Addresses

Other names 1

• CHERYL JACKSON OD PC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Margaret Ahuvah Severance, L.AC.

  • Acupuncturist
  • Lake Bluff, IL
  • NPI 1003038704
  NPD (past)

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1346485927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 EAST SCRANTON AVE",
            "address_2": "SUITE 203",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "60044",
            "telephone_number": "847-234-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E. SCRANTON AVE",
            "address_2": "SUITE 203",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "60044",
            "telephone_number": "847-234-7055",
            "fax_number": "847-234-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERYL JACKSON OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-10",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "OWNER, OD",
        "authorized_official_telephone_number": "847-234-7055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHERYL JACKSON OD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Lake Bluff, IL
• Providers in Lake Bluff, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.