Brianna Jackson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-77748 Issued in IL

Practice address

14225 S 95TH Ave Ste 453
Orland Park, IL 60462-2266

Phone

(708) 787-0952

NPI assigned

Jul 15, 2024

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": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1861239956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14225 S 95TH AVE STE 453",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622266",
            "telephone_number": "815-469-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14225 S 95TH AVE STE 453",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622266",
            "telephone_number": "708-787-0952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21000 S Frankfort Square Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "IL",
            "postal_code": "604239386",
            "country_code": "US",
            "telephone_number": "815-469-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-24-77748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Istre, M.S., CCC-SLP
• J L Imaging Inc
• Shadi Jabali
• Rachel Cuculich Jablonski, M.S. CCC-SLP/L
• Jack Czarlinskim.D.S.C.
• Michelle Jackson
• Mathew Jacob
• Namita Jacob
• Taylor Jacobs, LPC
• Sara Jadallah

• Behavior Analyst in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.