| Brian Jackson, | |
|
1125 N Delany Rd, Gurnee, IL 60031-2007 | |
| (800) 974-4378 | |
| (630) 515-1536 |
| Full Name | Brian Jackson |
|---|---|
| Gender | Male |
| Speciality | Occupational Therapist |
| Location | 1125 N Delany Rd, Gurnee, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245629583 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 056010871 (Illinois) | Primary |
| Provider Name | Dpt Holdings Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1689648602 PECOS PAC ID: 4688679293 Enrollment ID: O20061003000259 |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Jackson, 24014 W Renwick Rd Ste F, Plainfield, IL 60544-8708 Ph: (800) 974-4378 | Brian Jackson, 1125 N Delany Rd, Gurnee, IL 60031-2007 Ph: (800) 974-4378 |
Dynamic Hand Therapy & Rehabilitation Limited Partnership Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3900 Washington Street, Suite B, Gurnee, IL 60031 Phone: 847-336-2616 Fax: 847-336-2676 | |
Cheryl Oommen, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 350 S Greenleaf St, Suite 403, Gurnee, IL 60031 Phone: 847-596-7640 Fax: 847-596-7641 | |
Mckenna Ann Donegon, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 17281 W Maple Ln, Gurnee, IL 60031 Phone: 920-214-3032 | |
Marie Pedrola, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 30 Tower Ct Ste A, Gurnee, IL 60031 Phone: 847-336-1520 Fax: 847-336-1098 | |
Stacy Lynne Calcagnino, MSOTR L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1800 Nations Dr, Suite 208, Gurnee, IL 60031 Phone: 847-477-9034 | |
Marci Simmons, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3775 Grand Ave, Gurnee, IL 60031 Phone: 847-231-3141 | |
Twisha Patel, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 5363 Sequoia Ct, Gurnee, IL 60031 Phone: 224-627-2859 |