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MICHAEL K JACKSON MASTERS
NPI 1669236477
Clinic/Center - Adolescent and Children Mental Health in Eldorado, IL

Active since February 12, 2024
1200 LOCUST ST, ELDORADO, IL 62930(618) 252-9036 Get Directions Write a Review

NPPES record last updated: February 12, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Michael K Jackson Masters NPPES

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

MICHAEL K JACKSON MASTERS (NPI 1669236477) is an individual adolescent and children mental health provider in Eldorado, Illinois and active in the NPI registry since February 2024.

NPPES Registry Identity

NPI1669236477
Entity TypeIndividualMale
Primary Taxonomy261QM0855X
Provider Legal NameMICHAEL K JACKSONCredential: MASTERS
Location Address1200 LOCUST STEldorado, IL 62930-1723
Mailing Address1200 Locust StEldorado, IL 62930-1723 · (618) 252-9036
Phone(618) 252-9036
Sole ProprietorYes
Enumeration DateFebruary 12, 2024
NPPES CertifiedFebruary 12, 2024
✔ NPI 1669236477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0855X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
1200 LOCUST ST, Eldorado, IL 62930
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. FRANKO GILBERT TESTON
Psychologist (Counseling)
1200 LOCUST ST
ELDORADO, IL 62930
Saline County (618) 252-9036
JESSICA LYNNE TEPE
Psychologist (Counseling)
1200 LOCUST ST
ELDORADO, IL 62930
Saline County (618) 252-9036
MARANDA PEDIGO
Counselor
1200 LOCUST ST
ELDORADO, IL 62930
Saline County (618) 252-9036
OCTAVIA SWANGO MSW
Counselor
1200 LOCUST ST
ELDORADO, IL 62930
Saline County (618) 252-9036
RUMBIDZAI C CHISANGO
Counselor (Mental Health)
1200 LOCUST ST
ELDORADO, IL 62930
Saline County (618) 252-9036
DUSTY WILSON
Counselor
1200 LOCUST ST
ELDORADO, IL 62930
Saline County (618) 252-9036
TESLA TRAVELSTEAD MSW
Counselor
1200 LOCUST ST
ELDORADO, IL 62930
Saline County (618) 252-9036
BONNIE GLAD MS COUNSELING
Counselor (Mental Health)
1200 LOCUST ST
ELDORADO, IL 62930
Saline County (618) 252-9036

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 Michael Jackson's NPI number?

The NPI number for Michael Jackson is 1669236477. It was assigned to this individual provider in the NPPES registry on February 12, 2024.

Where is Michael Jackson located?

Michael Jackson practices at 1200 Locust St, Eldorado, IL 62930. The listed phone number is (618) 252-9036.

What is Michael Jackson's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

When was this NPI record last updated?

The NPPES record for Michael Jackson was last updated on February 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.