Individual provider · Type 1 NPI

Kurt H. Jackson

Professional Counselor · Chicago, IL

NPI number 1104178649 Active

Practice location

8044 S Racine Ave
Chicago, IL 60620-3011

Call (773) 723-9291 Map

Fax (773) 723-9291

Mailing address

2922 Chayes Park Dr
Homewood, IL 60430-2907

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor 101YP2500X178006138 (IL)
Professional Counselor Primary 101YP2500X180015933 (IL)

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About NPI 1104178649

Kurt H. Jackson's National Provider Identifier is 1104178649, issued on Oct 8, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Chicago, IL. The record was last updated on Oct 9, 2024.