MRS. NUSHA SYLAJ JACKSON (NPI# 1104462738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104462738 |
| Entity Type | Individual |
| Full Name | MRS. NUSHA SYLAJ JACKSON |
| Credential | FNP |
| Practice Address |
1656 N. Wells Chicago IL 60614-3224 |
| Mailing Address |
939 W Madison St Apt 307 Chicago IL 60607-2657 |
| Practice Telephone | 3126431333 |
| Mailing Telephone | 2487705168 |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2020-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP2201X |
Registered Nurse Specialization: Ambulatory Care |
041434377 | IL | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.021965 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1656 N. WELLS |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-3224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1881291706 | Rita Elue | Nurse Practitioner | 6241 N Winthrop Ave Apt 307, Chicago, IL 60660-2071 | 2020-10-04 |
| 1558976514 | Janice Nicole Kinney | Nurse Practitioner | 10127 S Harding Ave, Chicago, IL 60655-3748 | 2020-09-15 |
| 1881209278 | Monique Graves | Nurse Practitioner | 4912 W Adams St Apt 2, Chicago, IL 60644-4445 | 2020-09-11 |
| 1194339721 | Maureen Iyesogie Diji | Nurse Practitioner | 4658 S Ellis Ave, Chicago, IL 60653-3625 | 2020-09-01 |
| 1669085395 | Emily Calderon | Nurse Practitioner | 5556 N Sheridan Rd Apt 506, Chicago, IL 60640-1677 | 2020-08-24 |
| Find all providers in CHICAGO | ||||
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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.