Miss Latrice Jackson, is a
Registered Nurse based in Sauk Village, Illinois. Miss Latrice Jackson is licensed to practice in Illinois (license number 041398810) and her current practice location is
2010 216th St, Sauk Village, Illinois. She can be reached at her office (for appointments etc.) via phone at
(708) 668-5449.
NPI number for Miss Latrice Jackson is 1174352280 and her current mailing address is 14200 S Parnell Ave, Riverdale, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1174352280.
Provider's Profile
Full Name | Miss Latrice Jackson |
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Gender | Female |
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Speciality | Registered Nurse |
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Location | 2010 216th St, Sauk Village, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1174352280
- Provider Enumeration Date: 07/29/2024
- Last Update Date: 07/29/2024
Medical Identifiers
Medical identifiers for Miss Latrice Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1174352280 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 041398810 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Latrice Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Miss Latrice Jackson, 14200 S Parnell Ave, Riverdale, IL 60827-2313 Ph: (708) 668-5449 | Miss Latrice Jackson, 2010 216th St, Sauk Village, IL 60411-4506 Ph: (708) 668-5449 |
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