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General NPI Number Information
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NPI Number | 1184577520
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Entity Type | Individual
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Provider Name | ARLENE C JACKSON RN, MBA
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Gender | Female
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 8959 S OGLESBY AVE
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City | CHICAGO
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State | IL
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Zip | 60617-3048
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Country | US
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Telephone | 773-817-3572
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Fax |
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Provider Business Mailing Address
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Address Line | 8959 S OGLESBY AVE
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City | CHICAGO
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State | IL
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Zip | 60617-3048
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Country | US
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Telephone | 773-817-3572
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 041301090
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 041301090
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 041301090
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License Number State | IL
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