Gabrielle Elyse Jackson

Physical Therapy Assistant · Sullivan, IL

Individual Active NPI

NPI number 1982333472

Practice location

1 Masonic Way
Sullivan, IL 61951-9467
Phone
(217) 728-3700

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NPI record

NPI
1982333472
Entity type
Individual (Type 1)
Enumeration date
June 9, 2022
Last updated
June 9, 2022
Certified
June 9, 2022
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapy Assistant Primary 225200000X 160.007936 IL

Mailing address

2128 E 1525 North Rd
Shelbyville, IL 62565-4537
Phone
(217) 273-7930

About Gabrielle Jackson

Gabrielle Elyse Jackson is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapy Assistant (code 225200000X). The practice location is 1 Masonic Way, Sullivan, IL 61951-9467. The NPI number 1982333472 was assigned on June 9, 2022 and the record was last updated on June 9, 2022.

Gabrielle Jackson lists a license in the registry: #160.007936 (IL) for Physical Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Gabrielle Elyse Jackson?

The NPI number is 1982333472.

What is the phone number of Gabrielle Jackson?

The phone number listed for the practice location is (217) 728-3700.

Where is Gabrielle Jackson located?

1 Masonic Way, Sullivan, IL 61951-9467.

What is the taxonomy code for Gabrielle Jackson?

The primary taxonomy code is 225200000X – Physical Therapy Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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