Most Relevant Information
Provider Data
| NPI Number: | 1003006842 |
| Provider Name: | DEBORAH LEE JACKSON LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/27/2007 |
| Last Updated: | 07/27/2007 |
Provider Practice Location
2820 W PETERSON AVE
CHICAGO
IL
606593803
Practice Location Phone/Fax
| Phone: | 7732938437 |
| Fax: | 7737284751 |
Provider Mailing Location
2820 W. PETERSON AVE
CHICAGO
IL
60659
Provider Mailing Phone/Fax
| Phone: | 7732938437 |
| Fax: | 7737284751 |