DR. PETRINA JACKSON (NPI# 1295377240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295377240 |
| Entity Type | Individual |
| Full Name | DR. PETRINA JACKSON |
| Credential | DC |
| Practice Address |
4143 Sauk Trl Richton Park IL 60471-1253 |
| Mailing Address |
335 E Geneva Rd # 3042 Carol Stream IL 60188-2438 |
| Practice Telephone | 8448362867 |
| Mailing Telephone | 6308039679 |
| Mailing Fax Number | 8448362867 |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2020-11-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038.013330 | IL | Chiropractic Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1283 W Dundee Rd, Buffalo Grove, IL 600894009 | 8476329919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386881126 | Petrina M Jackson | Licensed Practical Nurse | 201 N Broadway Apt 3n, Yonkers, NY 10701-2608 | 2009-01-15 |
| 1952476822 | Petrina F Jackson | Speech-Language Pathologist | 12224 Fairway Cir, Unit A, Blue Island, IL 60406-3611 | 2006-11-22 |
| Street Address |
4143 SAUK TRL |
| City | RICHTON PARK |
| State | IL |
| Zip Code | 60471-1253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265430730 | Mercado Foot and Ankle Clinics | Podiatrist | 4143 Sauk Trl, Richton Park, IL 60471-1253 | 2005-07-08 |
| 1659451870 | Michael J Smith | Podiatrist | 4143 Sauk Trl, Richton Park, IL 60471-1253 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386119501 | Welllife Behavioral Services, LLC | Social Worker | 4137 Sauk Trail, Suite 100, Richton Park, IL 60471 | 2018-10-04 |
| 1891149332 | Wal-mart Stores, Inc. | Technician/Technologist | 22401 Central Avenue, Richton Park, IL 60471 | 2016-04-21 |
| 1689049744 | Lauren Michelle Jackson | Counselor | 1046 Lioncrest Drive, Richton Park, IL 60471 | 2015-12-01 |
| 1326420092 | Denny's Health Care Services Inc | In Home Supportive Care | 4912 Arquilla Drive, Richton Park, IL 60471 | 2015-06-18 |
| 1538312475 | Illinois Behavioral Services Inc | Psychologist | 276 E 16th Street, Chicago Heights, IL 60471 | 2008-10-23 |
| 1588876601 | Getting To Know Me & My World | Home Health | 22006 Jordan Lane, Richton Park, IL 60471 | 2007-05-03 |
| 1982711990 | Camille Yolanda Humes | Counselor | 4511 Sauk Trail, Richton Park, IL 60471 | 2006-08-24 |
| 1003329657 | Elizabeth Eileen Mcelligott | Speech-Language Pathologist | 5000 Sauk Trl, Richton Park, IL 60471-1000 | 2017-11-06 |
| 1629083811 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 4889 Sauk Trl, Richton Park, IL 60471-1017 | 2006-07-29 |
| 1811267933 | Dwayne Kerry Hall | Pharmacist | 4889 Sauk Trl, Richton Park, IL 60471-1017 | 2012-01-05 |
| Find all providers in zip 60471 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013922673 | Garth L. Edwards | Chiropractor | 22111 Governors Hwy, Richton Park, IL 60471-1249 | 2006-07-30 |
| 1760853857 | Edwards Chiropractic Clinic | Chiropractor | 22111 Governors Hwy, Richton Park, IL 60471-1249 | 2015-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861347 | Evan Charles Mojica | Chiropractor | 1803 W State St Ste 150, Geneva, IL 60134-3692 | 2020-11-06 |
| 1407454424 | Mikel Marshall | Chiropractor | 881 S Lorraine Rd Apt 103, Wheaton, IL 60189-6924 | 2020-10-12 |
| 1912505157 | David Anthony Wesdock | Chiropractor | 208 Parkinson St, Normal, IL 61761-3079 | 2020-10-10 |
| 1902403124 | Maranda Joe Humphreys | Chiropractor | 2150 Manchester Rd Ste 100, Wheaton, IL 60187-2474 | 2020-10-01 |
| 1023625654 | Kennedy Nicole Brauer | Chiropractor | 208 Flax Dr Ste 200, Highland, IL 62249-1394 | 2020-09-28 |
| 1649886730 | Simply Wellness Chiropractic, LLC | Chiropractor | 7117 Crimson Ridge Dr Ste 1, Rockford, IL 61107-6213 | 2020-09-23 |
| 1639785330 | Eve Marie Greenwell | Chiropractor | 143 N Henderson St, Mt Zion, IL 62549-1313 | 2020-09-17 |
| 1588279640 | Guadalupe Garcia | Chiropractor | 2745 Maple Ave Ste 2d, Lisle, IL 60532-3231 | 2020-09-14 |
| 1770197774 | Align Services Bloomington Pllc | Chiropractor | 2309 E Empire St Ste 200a, Bloomington, IL 61704-8636 | 2020-09-07 |
| 1881208080 | Christian James Koch | Chiropractor | 5100 N Ravenswood Ave Ste 107, Chicago, IL 60640-1710 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | RICHTON PARK |
| Zip Code | 60471 |
Please comment or provide details below to improve the information on DR. PETRINA JACKSON.
| 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.