Christopher Paul Jackson, MS ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

096002299 Issued in IL

Practice address

1051 W US RT 6
Suite 400
Morris, IL 60450

Phone

(815) 942-8301

Fax

(815) 942-8449

NPI assigned

Aug 14, 2008

Last updated

Aug 14, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1841446416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 W US RT 6",
            "address_2": "SUITE 400",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "60450",
            "telephone_number": "815-942-8301",
            "fax_number": "815-942-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 W US RT 6",
            "address_2": "SUITE 400",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "60450",
            "telephone_number": "815-942-8301",
            "fax_number": "815-942-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "PAUL",
        "credential": "MS ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-14",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "096002299",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096002299",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katia V Ilieva, M.D.
• Illinois Valley Industries, Inc.
• Innerflow Counseling
• Institute for Personal Development
• Michael T Jachec, M.D.
• Morgan Taylor Jackson, APRN
• Reilly Anne Jaeger, PT, DPT
• Keith W Jaeschke, D.D.S.
• Timberlie R Jahn, ALMFT
• Lukas Jakubonis, PA-C

• Physical Therapist in Morris, IL
• Providers in Morris, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.