MARYLYN JACKSON (NPI# 1023359510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023359510 |
| Entity Type | Individual |
| Full Name | MARYLYN JACKSON |
| Practice Address |
2555 Lincoln Hwy Suite 113 Olympia Fields IL 60461-1936 |
| Practice Telephone | 7086790668 |
| Mailing Telephone | 7086790668 |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2013-03-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 019-017207 | IL | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019-017207 | IL | Dental Providers |
| Street Address |
2555 LINCOLN HWY SUITE 113 |
| City | OLYMPIA FIELDS |
| State | IL |
| Zip Code | 60461-1936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790780344 | Robert C Watkins Jr. | Family Medicine | 2555 Lincoln Hwy, Suite 206, Olympia Fields, IL 60461-1936 | 2005-06-20 |
| 1306241922 | Neil P. Parikh D.d.s., P.c | Dentist | 2555 Lincoln Hwy, Suite 107, Olympia Fields, IL 60461-1936 | 2014-10-24 |
| 1407284979 | Duni Women's Healthcare P.C. | Nurse Practitioner | 2555 Lincoln Hwy, Ste 205 A, Olympia Fields, IL 60461-1936 | 2013-10-21 |
| 1457659294 | Cn Hearing Care, Inc | Hearing Aid Equipment | 2555 Lincoln Hwy, Suite 108, Olympia Fields, IL 60461-1936 | 2011-03-02 |
| 1083855167 | 1st Choice Medical Supplies, Inc. | Durable Medical Equipment & Medical Supplies | 2555 Lincoln Hwy, Olympia Fields, IL 60461-1936 | 2009-03-18 |
| 1205071818 | Vicente F Sahig Md Sc | Clinic/Center | 2555 Lincoln Hwy, Suite 106, Olympia Fields, IL 60461-1936 | 2008-12-10 |
| 1598919011 | Roshan P. Parikh, D.d.s. M.b.a. P.C. | Dentist | 2555 Lincoln Hwy, Suite 107, Olympia Fields, IL 60461-1936 | 2008-11-11 |
| 1871749275 | Jacob D Darragh | Physical Therapist | 2555 Lincoln Hwy, Suite 102, Olympia Fields, IL 60461-1936 | 2008-08-18 |
| 1003070798 | Roshan P Parikh | Dentist | 2555 Lincoln Hwy, Suite 107, Olympia Fields, IL 60461-1936 | 2008-07-11 |
| 1730340332 | James S. Habib, Md, Ltd | Internal Medicine | 2555 Lincoln Hwy, Suite 101, Olympia Fields, IL 60461-1936 | 2008-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609372564 | Katherine Gill Haddad | Student in an Organized Health Care Education/Training Program | 20201 S. Crawford Avenue, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2018-03-31 |
| 1750886610 | Kim Minh Dang | Student in an Organized Health Care Education/Training Program | 20201 South Crawford, Olympia Fields, IL 60461 | 2018-03-23 |
| 1619484110 | Alexandra N. Douvas | Dentist | 20180 Governors Hwy, Ste 104, Olympia Fields, IL 60461 | 2018-01-05 |
| 1992258438 | Krystyne Doty | Nurse Practitioner | 3800 W 203rd St Ste 209, Olympia Fields, IL 60461 | 2016-08-02 |
| 1205286747 | Shirlene Umali | Registered Nurse | 20201 South Crawford Ave, Olympia Fields, IL 60461 | 2016-06-15 |
| 1386002590 | Touch of Wholeness Psychological Services, LLC | Psychologist | 20280 Governors Dr, Suite 207, Olympia Fields, IL 60461 | 2016-02-02 |
| 1063895357 | David Dardick | Dentist | 20180 Governors Hwy Ste 104, Olympia Fields, IL 60461 | 2015-07-04 |
| 1811378623 | Fins Healthcare Agency | Nursing Care | 3612 Lincohn Highway, Suite 19, Olympia Fields, IL 60461 | 2015-06-17 |
| 1285048959 | Garud Ranga Raj | Orthopaedic Surgery | 20817 Alexander St, Olympia Fields, IL 60461 | 2014-06-20 |
| 1811316334 | Brett Hapeman | Emergency Medicine | 20201 S Crawford, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2014-04-11 |
| Find all providers in zip 60461 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063895357 | David Dardick | Dentist | 20180 Governors Hwy Ste 104, Olympia Fields, IL 60461 | 2015-07-04 |
| 1619095593 | Jack C Yi | Dentist | 3240 Vollmer Rd, Olympia Fields, IL 60461-1122 | 2007-03-27 |
| 1578680625 | Progressive Dental and Assoc PC | Dentist | 3494 Vollmer Road, Olympia Fields, IL 60461 | 2007-03-23 |
| 1881701621 | Kapmarski, LLC | Dentist | 2605 W Lincoln Highway, Suite 124, Olympia Fields, IL 60461 | 2006-08-25 |
| 1598919011 | Roshan P. Parikh, D.d.s. M.b.a. P.C. | Dentist | 2555 Lincoln Hwy, Suite 107, Olympia Fields, IL 60461-1936 | 2008-11-11 |
| 1932372547 | Gordon Dental Associates, Ltd. | Dentist | 2555 Lincoln Hwy, Suite 109, Olympia Fields, IL 60461-1936 | 2008-04-04 |
| 1023296613 | Linisha Mills | Dentist | 2555 Lincoln Hwy, Suite 111, Olympia Fields, IL 60461-1936 | 2008-02-05 |
| 1407066160 | Ralph Edwin Woerheide | Dentist | 2601 Lincoln Hwy, Olympia Fields, IL 60461-1862 | 2007-05-23 |
| 1184844953 | 3d Dental Services - Ltd | Dentist | 19900 Governors Dr, Suite 102, Olympia Fields, IL 60461-1057 | 2007-04-26 |
| 1407905169 | Summerset Dental Care | Dentist | 3612 Lincoln Hwy, Suite 18, Olympia Fields, IL 60461-1627 | 2007-01-10 |
| Find all providers in OLYMPIA FIELDS | ||||
| City | OLYMPIA FIELDS |
| Zip Code | 60461 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.