Sarah R Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

161 Northfield Rd
Northfield, IL 60093-3389

Phone

(847) 784-6000

Fax

(847) 784-6014

NPI assigned

Jun 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Shore Senior CenterGroup PAC ID 3072814516, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• North Shore Senior Center

  • Case Manager/Care Coordinator
  • Northfield, IL
  • NPI 1912259425

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1124409891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 NORTHFIELD RD",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933389",
            "telephone_number": "847-784-6000",
            "fax_number": "847-784-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 NORTHFIELD RD",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933389",
            "telephone_number": "847-784-6000",
            "fax_number": "847-784-6014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 W Elk Grove Blvd",
            "address_purpose": "LOCATION",
            "city": "Elk Grove Village",
            "state": "IL",
            "postal_code": "600074261",
            "country_code": "US",
            "telephone_number": "847-716-0473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SARAH",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014103",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nicholas Barclay Jackson, M.A.
• Sarah Rae Jacobs, MSW
• Ejaz Nazeer Jafri, APN
• Maja Jakovljevic, PSYD
• Susan Ashley Jara, RN
• Wanasinghe Jayasena, P.T.

• Clinical Social Worker in Northfield, IL
• Providers in Northfield, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.