Letha Annissa Bell-Jackson

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

License

1982988 Issued in IL

Practice address

4302 Oak St
Bellwood, IL 60104-1312

Phone

(630) 927-1106

NPI assigned

Jan 30, 2025

Last updated

Jan 30, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1649083718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 OAK ST",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601041312",
            "telephone_number": "630-927-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 OAK ST",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601041312",
            "telephone_number": "630-927-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELL-JACKSON",
        "first_name": "LETHA",
        "middle_name": "ANNISSA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": "1982988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leticia Avila, QMHP
• Shamika Battles
• Rachel Lynne Baugues, PA-C
• Alysia Sara Beirne, PT, DPT
• Believe in Breath LLC
• Bellwood Nursing Center LLC
• Emily E Benedict, COTA
• Caitlin Rebecca Bodner, DNP, FNP-C
• Broadway Medical Clinic, SC
• Angela Nicole Broom, L.C.S.W.

• Developmental Therapist in Bellwood, IL
• Providers in Bellwood, IL by specialty
• Developmental Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.