CARMELLA JACKSON
NPI 1336782200
Nurse Practitioner - Family in Matteson, IL

Q: What is Carmella Jackson's NPI number?

The NPI number for Carmella Jackson is 1336782200. It was assigned to this individual provider in the NPPES registry on October 23, 2019.

Q: What is Carmella Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Carmella Jackson was last updated on October 23, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 23, 2019

916 SCHOOL AVE, MATTESON, IL 60443(773) 941-1587 Get Directions Write a Review

NPPES record last updated: October 23, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Carmella Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARMELLA JACKSON (NPI 1336782200) is an individual family provider in Matteson, Illinois, licensed in Illinois (209020232) and active in the NPI registry since October 2019.

NPPES Registry Identity

NPI1336782200

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameCARMELLA JACKSON

Location Address916 SCHOOL AVEMatteson, IL 60443-1832

Mailing Address916 School AveMatteson, IL 60443-1832 · (773) 941-1587

Phone(773) 941-1587

Sole ProprietorNo

Enumeration DateOctober 23, 2019

✔ NPI 1336782200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IL · 209020232

916 SCHOOL AVE, Matteson, IL 60443

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carmella Jackson's NPI number?

The NPI number for Carmella Jackson is 1336782200. It was assigned to this individual provider in the NPPES registry on October 23, 2019.

Where is Carmella Jackson located?

Carmella Jackson practices at 916 School Ave, Matteson, IL 60443. The listed phone number is (773) 941-1587.

What is Carmella Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Carmella Jackson was last updated on October 23, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.