| Doctor Name: | MS. ANN WILBORN JACKSON |
| NPI Number: | 1073668810 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | |
| Business Practice Address: | 18860 Hamlin Ave Flossmoor, IL - 604221046 |
| Business Phone Number: | 7089220741 |
| Business Fax Number: | 7089220196 |
| Mailing Address: | 18860 Hamlin Ave, FLOSSMOOR |
| State: | IL |
| Postal Code: | 604221046 |
| Phone Number: | 7089220741 |
| Fax Number: | 7089220196 |
| NPI Enumeration Date: | 01/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251N0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Neurology |
| Taxonomy Definition: | |