Denise L Jackson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036094604 Issued in IL

Practice address

10043 W Lincoln Hwy
Frankfort, IL 60423-1272

Phone

(708) 709-9300

Fax

(708) 709-6353

NPI assigned

May 17, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Blue Island Clinic Company LLC

  • Internal Medicine Physician
  • Blue Island, IL
  • NPI 1609148139

  Family Medicine

  NPD (past)
• Riverside Health System

  • Psychiatry Physician
  • Kankakee, IL
  • NPI 1336354430
  NPD (past)
• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1871545772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 DIXIE HWY",
            "city": "CHICAGO HTS",
            "state": "IL",
            "postal_code": "604111748",
            "telephone_number": "708-756-0100",
            "fax_number": "708-709-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10043 W LINCOLN HWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231272",
            "telephone_number": "708-709-9300",
            "fax_number": "708-709-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DENISE",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036094604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00450388/C K6882",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC GROUP",
            "identifier": "4673170001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inspire Home Health Services Inc.
• Instantpharmacy LLC
• Integrative Diagnostics
• Internal Medicine Physicians Inc.
• Tasnim Jaber
• Quanisha Jackson
• Tiara Jackson, LPC
• Nora Jaffal
• Zachary G Jagmin, DPM
• Kishor Nathmal Jain, MD

• Family Medicine Physician in Frankfort, IL
• Providers in Frankfort, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.