Mitchell A Jackson (NPI# 1902958929, PAC ID# 6406748169) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPHTHALMOLOGY.
| Nation Provider ID (NPI) | 1902958929 |
| PAC ID by PECOS | 6406748169 |
| Professional Enrollment ID | I20040327000088 |
| Full Name | Mitchell A Jackson |
| Organization Legal Name | JACKSONEYE SC |
| Address |
300 N Milwaukee Ave L Lake Villa IL 60046-8563 |
| Phone Number | 8473560700 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 1989 |
| Primary Specialty | OPHTHALMOLOGY |
| Group Practice PAC ID | 3072405737 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140084 | VISTA MEDICAL CENTER EAST |
| Address | Phone | Organization |
|---|---|---|
| 300 N Milwaukee Ave L, Lake Villa, IL 60046-8563 | 8473560700 | JACKSONEYE SC |
| Organization Legal Name | JACKSONEYE SC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anna Michelle Edmiston | Ophthalmology | Jacksoneye Sc | 300 N Milwaukee Ave L, Lake Villa, IL 60046-8563 |
| Gabriela Juliana Trabal-yulfo | Ophthalmology | Jacksoneye Sc | 300 N Milwaukee Ave L, Lake Villa, IL 60046-8563 |
| Melissa Kay Bollinger | Optometry | Jacksoneye Sc | 300 N Milwaukee Ave L, Lake Villa, IL 60046-8563 |
| Street Address |
300 N MILWAUKEE AVE L |
| City | LAKE VILLA |
| State | IL |
| Zip | 60046-8563 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anna Michelle Edmiston | Ophthalmology | Jacksoneye Sc | 300 N Milwaukee Ave L, Lake Villa, IL 60046-8563 |
| Gabriela Juliana Trabal-yulfo | Ophthalmology | Jacksoneye Sc | 300 N Milwaukee Ave L, Lake Villa, IL 60046-8563 |
| Melissa Kay Bollinger | Optometry | Jacksoneye Sc | 300 N Milwaukee Ave L, Lake Villa, IL 60046-8563 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert A Dickstein | Diagnostic Radiology | Vista Imaging Associates Sc | 1050 Red Oak Ln, Lindenhurst, IL 60046-4998 |
| Craig A Davishoff | Diagnostic Radiology | Vista Imaging Associates Sc | 1050 Red Oak Ln, Lindenhurst, IL 60046-4998 |
| Neil H Puller | Diagnostic Radiology | Vista Imaging Associates Sc | 1050 Red Oak Ln, Lindenhurst, IL 60046-4998 |
| Lauren T Gruber | Physical Therapy | Illinois Bone and Joint Institute LLC | 1025 Red Oak Ln, Suite 100, Lindenhurst, IL 60046-5017 |
| Elina Shapiro | Physical Therapy | Illinois Bone and Joint Institute LLC | 1025 Red Oak Ln, Suite 100, Lindenhurst, IL 60046-5017 |
| Scott Anthony Jacobsen | Podiatry | Illinois Bone and Joint Institute LLC | 1025 Red Oak Ln, Suite 100, Lindenhurst, IL 60046-5017 |
| Catherine M Goodale | Nurse Practitioner | Waukegan Clinic Corp | 1025 Red Oak Ln, Suite 120, Lindenhurst, IL 60046-5017 |
| Spring Evans | Physical Therapy | Adult and Pediatric Orthopedics, S.c | 50 S Milwaukee Ave, Suite 201, Lake Villa, IL 60046-5426 |
| Jeffrey B Wells | Chiropractic | Advanced Chiropractic and Acupuncture Center | 2450 E Grasslake Rd D, Lindenhurst, IL 60046-5607 |
| Lawrence G Needham | Chiropractic | 1512 N Cedar Lake Rd, Lake Villa, IL 60046-6404 | |
| Find all physicians in zip 60046 | |||
| City | LAKE VILLA |
| Zip Code | 60046 |
| Specialty | OPHTHALMOLOGY |
| City + Specialty | LAKE VILLA + OPHTHALMOLOGY |
Please comment or provide details below to improve the information on Mitchell A Jackson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.