Individual provider · Type 1 NPI
Amani Dianne Jackson
Student in an Organized Health Care Education/Training Program · Matteson, IL
NPI number
1962864447
Active
Practice location
3631 213th St
Matteson, IL 60443-2510
Mailing address
1020 Park Drive, P.o. Box #725
Flossmoor, IL 60422
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Athletic Trainer | 2255A2300X | None listed |
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Other student in an organized health care education/training program providers in Matteson
About NPI 1962864447
Amani Dianne Jackson's National Provider Identifier is 1962864447, issued on Mar 24, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Matteson, IL. The record was last updated on Mar 24, 2016.