DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: JA'TAIVEUS DE'AARON JACKSON

MEDICARE: JA'TAIVEUS DE'AARON JACKSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1356289417
Entity Type Code : Individual
Provider Name (Legal Business Name) : JA'TAIVEUS DE'AARON JACKSON
Provider Business Mailing Address
First Line : 225 E CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2991
Country : US
Telephone Number : 312-227-4000
Fax Number :
Provider Business Practice Location Address
First Line : 225 E CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2991
Country : US
Telephone Number : 312-227-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

Similar Medicare Providers

1801734082 — EMILY ANN WILT MD
Practice Location Address:
225 E CHICAGO AVE
CHICAGO, IL
60611-2991
Practice Phone: 312-227-4000
Practice Fax:
1285572404 — AMY FRENKEL MD
Practice Location Address:
225 E CHICAGO AVE
CHICAGO, IL
60611-2991
Practice Phone: 312-227-4000
Practice Fax:
1356289573 — RACHEL ANN REZABEK MD
Practice Location Address:
225 E CHICAGO AVE
CHICAGO, IL
60611-2991
Practice Phone: 312-227-4000
Practice Fax:
1558209643 — ALEX F NISBET MD
Practice Location Address:
225 E CHICAGO AVE
CHICAGO, IL
60611-2991
Practice Phone: 312-227-4000
Practice Fax:
1164360087 — MICHAEL JOHN FITZPATRICK
Practice Location Address:
225 E CHICAGO AVE
CHICAGO, IL
60611-2991
Practice Phone: 312-227-4000
Practice Fax:
1790202901 — SAMANTHA SCHROTH
Practice Location Address:
225 E CHICAGO AVE
CHICAGO, IL
60611-2991
Practice Phone: 312-227-4000
Practice Fax:

Directions to “ JA'TAIVEUS DE'AARON JACKSON ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.