Individual provider · Type 1 NPI
Kesha Douglas-Jackson, APN
Family Nurse Practitioner · Maywood, IL
NPI number
1720598071
Active
Practice location
2160 S 1st Ave
Maywood, IL 60153-3328
Fax (708) 795-0101
Mailing address
PO Box 74008272
Chicago, IL 60674-8272
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 209016670 (IL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1720598071
Kesha Douglas-Jackson, APN's National Provider Identifier is 1720598071, issued on Oct 1, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Maywood, IL. The record was last updated on Oct 8, 2025.