Evan Leigh Jackson, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036155621 Issued in IL

Practice address

1740 W Taylor St
Chicago, IL 60612-7232

Phone

(866) 600-2273

NPI assigned

Mar 26, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Touro Un College of Osteopathic Medicine, Vallejo, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Cross Hospital Hospital, Chicago, IL, CCN 140133
• Mt Sinai Hospital Medical Center Hospital, Chicago, IL, CCN 140018
• Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179
• University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ejackson17982@uihealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527

  Multi-Specialty

  Medicare reassignment NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1265954465

  Multi-Specialty

  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1871360297

  Multi-Specialty

  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holy Cross Hospital

  • Psychiatric Hospital Unit
  • Chicago, IL
  • NPI 1427547538
  Care Compare affiliation
• Holy Cross Hospital

  • Substance Abuse Rehabilitation Facility
  • Chicago, IL
  • NPI 1770335770

  Hospital

  Care Compare affiliation
• Holy Cross Hospital

  • Substance Abuse Rehabilitation Facility
  • Chicago, IL
  • NPI 1821840828

  Hospital

  Care Compare affiliation
• Holy Cross Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1962425611
  Care Compare affiliation
• Mount Sinai Hospital Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1871581314
  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Evergreen Park, IL
  • NPI 1215572045
  Care Compare affiliation
• The Board of Trustees of the University of Illinois

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1861431751
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1013412634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 SOUTH WOOD STREET",
            "address_2": "469 CME, M/C 724",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-413-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "EVAN",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02006363A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.073354",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036155621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ejackson131555@direct.luhs.org",
            "affiliation": "Y",
            "endpointDescription": "ejackson131555@direct.luhs.org",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Jackson
• Deanna Jackson
• Deborah Lee Jackson, LCSW
• Devonna Jackson, MA, LCPC
• Ecola Jackson, CPHT
• Felicia Jackson, RN
• Gabrielle Tynisha Jackson
• Gale Victoria Jackson, NP
• Gregory Wayne Jackson, DDS
• Ida B Jackson, LCPC,

• Emergency Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.